Restricted accessResearch articleFirst published online 2018-8
Effects of contrast-enhancement on diffusion weighted imaging and apparent diffusion coefficient measurements in 3-T magnetic resonance imaging of breast lesions
The effect of gadolinium-based contrast agents on diffusion-weighted imaging (DWI) measurements of breast lesions is still not clear.
Purpose
To investigate gadolinium effects on DWI and apparent diffusion coefficient (ADC) in breast lesions and normal parenchyma with 3 Tesla contrast-enhanced MRI.
Material and Methods
Pre- and post-contrast DWI (b = 0 and b = 1000 s/mm2) were acquired in 47 patients. Measured ADC values, pre- and post-contrast T2 signal intensity (T2 SI) and contrast-to-noise ratio (CNR) were compared with Wilcoxon signed-rank and rank-sum test (P < 0.05).
Results
Post-contrast ADC was reduced only in malignant lesions (−34%), T2 SI was reduced both in malignant (−50%) and benign (−36%) lesions. Post-contrast CNR was reduced in all groups except for benign lesions.
Conclusion
Gadolinium-based contrast agent causes a significant reduction in ADC values of malignant breast lesions.
PilewskieMKingTA. Magnetic resonance imaging in patients with newly diagnosed breast cancer: a review of the literature. Cancer2014; 120: 2080–2089.
2.
MorrowM. Magnetic resonance imaging for screening, diagnosis and eligibility for breast-conserving surgery: promises and pitfalls. SurgOncolClin N Am2010; 19: 475–492.
3.
PlanaMNCarreiraCMurielAet al.Magnetic resonance imaging in the preoperative assessment of patients with primary breast cancer: systematic review of diagnostic accuracy and meta-analysis. Eur Radiol2012; 22: 26–38.
4.
LeachMO. Application of magnetic resonance imaging to angiogenesis in breast cancer. Breast Cancer Res2008; 10: 260–266.
5.
GordonYPartoviSMüller-EschnerMet al.Dynamic contrast-enhanced magnetic resonance imaging: fundamentals and application to the evaluation of the peripheral perfusion. Cardiovasc Diagn Ther2014; 4: 147–164.
6.
PetersNHBorel RinkesIHZuithoffNPet al.Meta-analysis of MR imaging in the diagnosis of breast lesions. Radiology2008; 246: 116–124.
7.
El KhouliRHJacobsMAMezbanSDet al.Diffusion-weighted imaging improves the diagnostic accuracy of conventional 3.0-T breast MR imaging. Radiology2010; 256: 64–73.
8.
PartridgeSCDeMartiniWBKurlandBFet al.Quantitative diffusion-weighted imaging as an adjunct to conventional breast MRI for improved positive predictive value. Am J Roentgenol2009; 193: 1716–1722.
9.
ParsianSRahbarHAllisonKHet al.Nonmalignant breast lesions: ADCs of benign and high-risk subtypes assessed as false-positive at dynamic enhanced MR imaging. Radiology2012; 265: 696–706.
10.
GuoYCaiYQCaiZLet al.Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging. Journal of magnetic resonance imaging: JMRI2002; 16: 172–178.
11.
WoodhamsRMatsunagaKIwabuchiKet al.Diffusion-weighted imaging of malignant breast tumors: the usefulness of apparent diffusion coefficient (ADC) value and ADC map for the detection of malignant breast tumors and evaluation of cancer extension. J Comput Assist Tomogr2005; 29: 644–649.
12.
SardanelliFBoetesCBorischBet al.Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer2010; 46: 1296–1316.
13.
MannRMKuhlCKKinkelKet al.Breast MRI: guidelines from the European Society of Breast Imaging. Eur Radiol2008; 7: 1307–1318.
14.
Morris EA, Cornstock CE, Lee CH, et al. ACR BI-RADS® Magnetic Resonance Imaging. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA: ACR, 2013.
15.
YuenSYamadaKGotoMet al.Microperfusion-induced elevation of ADC is suppressed after contrast in breast carcinoma. J Magn Reson Imaging2009; 29: 1080–1084.
16.
YamadaKKubotaHKizuOet al.Effect of intravenous gadolinium-DTPA on diffusion-weighted images: evaluation of normal brain and infarcts. Stroke2002; 33: 1799–1802.
17.
LiuXZhouLPengWet al.Effect of intravenous gadolinium-DTPA on diffusion-weighted imaging for prostate lesions and normal tissue at 3.0-Tesla magnetic resonance imaging. Acta Radiol2011; 52: 575–580.
18.
FiratAKSanliBKarakasHMet al.The effect of intravenous gadolinium-DTPA on diffusion-weighted imaging. Neuroradiology2006; 48: 465–470.
19.
ChiuFYJaoJCChenCYet al.Effect of intravenous gadolinium-DTPA on diffusion-weighted magnetic resonance images for evaluation of focal hepatic lesions. J Comput Assist Tomogr2005; 29: 176–180.
20.
ChenGJespersenSNPedersenMet al.Intravenous administration of Gd-DTPA prior to DWI does not affect the apparent diffusion constant. Magn Reson Imaging2005; 23: 685–689.
21.
NguyenVTRahbarHOlsonMLet al.Diffusion-weighted imaging: effects of intravascular contrast agents on apparent diffusion coefficient measures of breast malignancies at 3 Tesla. J Magn Reson Imaging2015; 42: 788–800.
22.
JankaRHammonMGeppertCet al.Diffusion-weighted MR imaging of benign and malignant breast lesions before and after contrast enhancement. Rofo2014; 186: 130–135.
23.
FedorovABeichelRKalpathy-CramerJet al.3D slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging2012; 30: 1323–1341.
24.
Kobus T, Fedorov A, Tempany CM, et al. Bi-exponential diffusion analysis in normal prostate and prostate cancer: transition zone and peripheral zone considerations. The International Society for Magnetic Resonance in Medicine 23r Scientific Meeting and Exhibition, 2015 May, Toronto, Canada. Available at: http://www.spl.harvard.edu/abstracts/item/view/168 (accessed 17 February 2017).
25.
A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing. Available at: https://www.R-project.org (accessed 17 February 2017).
26.
RobinXTurckNHainardAet al.pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics2011; 12: 77–77.
27.
RamadanSMulkernRV. Comment on ADC reductions in postcontrast breast tumors. J Magn Reson Imaging2010; 31: 262–262. ; author reply 263–264.
28.
PintaskeJMartirosianPGrafHet al.Relaxivity of gadopentetate dimeglumine (Magnevist), gadobutrol (Gadovist), and gadobenate dimeglumine (MultiHance) in human blood plasma at 0.2, 1.5, and 3 Tesla. Invest Radiol2006; 41: 213–221.
29.
MartincichLFaivre-PierretMZechmannCMet al.Multicenter, double-blind, randomized, intraindividual crossover comparison of gadobenate dimeglumine and gadopentetate dimeglumine for Breast MR imaging (DETECT Trial). Radiology2011; 258: 396–408.
30.
PereiraFPMartinsGFigueiredoEet al.Assessment of breast lesions with diffusion-weighted MRI: comparing the use of different b values. Am J Roentgenol2009; 193: 1030–1035.
