Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Eur Radiol. 2024 Jul;34(7):4730-4737. doi: 10.1007/s00330-023-10321-y. Epub 2023 Nov 27.
To compare image quality of diffusion-weighted imaging (DWI) and contrast-enhanced breast MRI (DCE-T1) stratified by the amount of fibroglandular tissue (FGT) as a measure of breast density.
Retrospective, multi-reader, bicentric visual grading analysis study on breast density (A-D) and overall image and fat suppression quality of DWI and DCE-T1, scored on a standard 5-point Likert scale. Cross tabulations and visual grading characteristic (VGC) curves were calculated for fatty breasts (A/B) versus dense breasts (C/D).
Image quality of DWI was higher in the case of increased breast density, with good scores (score 3-5) in 85.9% (D) and 88.4% (C), compared to 61.6% (B) and 53.5% (A). Overall image quality of DWI was in favor of dense breasts (C/D), with an area under the VGC curve of 0.659 (p < 0.001). Quality of DWI and DCE-T1 fat suppression increased with higher breast density, with good scores (score 3-5) for 86.9% and 45.7% of density D, and 90.2% and 42.9% of density C cases, compared to 76.0% and 33.6% for density B and 54.7% and 29.6% for density A (DWI and DCE-T1 respectively).
Dense breasts show excellent fat suppression and substantially higher image quality in DWI images compared with non-dense breasts. These results support the setup of studies exploring DWI-based MR imaging without IV contrast for additional screening of women with dense breasts.
Our findings demonstrate that image quality of DWI is robust in women with an increased amount of fibroglandular tissue, technically supporting the feasibility of exploring applications such as screening of women with mammographically dense breasts.
• Image and fat suppression quality of diffusion-weighted imaging are dependent on the amount of fibroglandular tissue (FGT) which is closely connected to breast density. • Fat suppression quality in diffusion-weighted imaging of the breast is best in women with a high amount of fibroglandular tissue. • High image quality of diffusion-weighted imaging in women with a high amount of FGT in MRI supports that the technical feasibility of DWI can be explored in the additional screening of women with mammographically dense breasts.
通过测量乳腺内纤维腺体组织（fibroglandular tissue，FGT）的含量（即乳房密度）来比较弥散加权成像（diffusion-weighted imaging，DWI）和对比增强乳腺磁共振成像（contrast-enhanced breast MRI，DCE-T1）的图像质量。
这是一项回顾性、多读者、双中心的视觉分级分析研究，对乳腺密度（A-D）和 DWI 及 DCE-T1 的整体图像和脂肪抑制质量进行了评估，采用标准的 5 分李克特量表进行评分。对脂肪型乳房（A/B）和致密型乳房（C/D）进行交叉列表和视觉分级特征（visual grading characteristic，VGC）曲线分析。
随着乳房密度的增加，DWI 的图像质量更高，其中 85.9%（D）和 88.4%（C）的评分较好（评分 3-5），而 61.6%（B）和 53.5%（A）的评分较差。DWI 的整体图像质量有利于致密型乳房（C/D），VGC 曲线下面积为 0.659（p < 0.001）。随着乳房密度的增加，DWI 和 DCE-T1 的脂肪抑制质量也有所提高，其中 86.9%和 45.7%的 D 型密度、90.2%和 42.9%的 C 型密度评分较好，而 76.0%和 33.6%的 B 型密度、54.7%和 29.6%的 A 型密度评分较差（DWI 和 DCE-T1 分别）。
与非致密型乳房相比，致密型乳房的 DWI 图像具有出色的脂肪抑制效果和更高的图像质量。这些结果支持了使用基于弥散加权成像的磁共振成像（MR imaging）进行无静脉注射造影剂的额外筛查，以检查致密型乳腺的研究。
本研究结果表明，在乳腺内纤维腺体组织含量增加的情况下，DWI 的图像质量是可靠的，这从技术上支持了探索应用于乳腺钼靶摄影致密型乳腺筛查的可能性。
弥散加权成像的图像和脂肪抑制质量取决于纤维腺体组织（fibroglandular tissue，FGT）的含量，而 FGT 含量与乳房密度密切相关。
乳腺弥散加权成像的脂肪抑制质量在纤维腺体组织含量高的女性中最佳。
高含量 FGT 的女性的弥散加权成像具有较高的图像质量，这支持在乳腺钼靶摄影致密型乳腺的额外筛查中可以探索弥散加权成像的技术可行性。
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