Iima Mami, Honda Maya, Satake Hiroko, Kataoka Masako
Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan.
Jpn J Radiol. 2025 Mar;43(3):347-354. doi: 10.1007/s11604-024-01696-z. Epub 2024 Dec 6.
Recent advancements in breast magnetic resonance imaging (MRI) have significantly enhanced breast cancer detection and characterization. Breast MRI offers superior sensitivity, particularly valuable for high-risk screening and assessing disease extent. Abbreviated protocols have emerged, providing efficient cancer detection while reducing scan time and cost. Diffusion-weighted imaging (DWI), a non-contrast technique, has shown promise in differentiating malignant from benign lesions. It offers shorter scanning times and eliminates contrast agent risks. Apparent diffusion coefficient (ADC) values provide quantitative measures for lesion characterization, potentially reducing unnecessary biopsies. Studies have revealed some correlations between ADC values and hormone receptor status in breast cancers, although substantial variability exists among studies. However, standardization remains challenging. Initiatives such as European Society of Breast Imaging (EUSOBI), Diffusion-Weighted Imaging Screening Trial (DWIST), Quantitative Imaging Biomarkers Alliance (QIBA) have proposed guidelines to ensure consistency in imaging protocols and equipment specifications, addressing variability in ADC measurements across different sites and vendors. Advanced techniques like Intravoxel incoherent motion (IVIM) and non-Gaussian DWI offer insights into tissue microvasculature and microstructure. Despite ongoing challenges, the integration of these advanced MRI techniques shows great promise for improving breast cancer diagnosis, characterization, and treatment planning. Continued research and standardization efforts are crucial for maximizing the potential of breast DWI in enhancing patient care and outcomes.
乳腺磁共振成像（MRI）的最新进展显著提高了乳腺癌的检测和特征描述能力。乳腺MRI具有卓越的敏感性，对高危筛查和评估疾病范围尤为重要。简化方案已经出现，在减少扫描时间和成本的同时实现了高效的癌症检测。扩散加权成像（DWI）作为一种非对比技术，在鉴别恶性与良性病变方面显示出前景。它扫描时间更短，且消除了造影剂风险。表观扩散系数（ADC）值为病变特征描述提供了定量指标，有可能减少不必要的活检。研究揭示了乳腺癌ADC值与激素受体状态之间的一些相关性，尽管各研究之间存在很大差异。然而，标准化仍然具有挑战性。欧洲乳腺影像学会（EUSOBI）、扩散加权成像筛查试验（DWIST）、定量影像生物标志物联盟（QIBA）等组织已经提出了指导方针，以确保成像方案和设备规格的一致性，解决不同部位和供应商之间ADC测量的差异性问题。体素内不相干运动（IVIM）和非高斯DWI等先进技术为组织微血管结构和微观结构提供了深入见解。尽管仍存在挑战，但这些先进MRI技术的整合在改善乳腺癌诊断、特征描述和治疗规划方面显示出巨大潜力。持续的研究和标准化工作对于最大化乳腺DWI在改善患者护理和治疗结果方面的潜力至关重要。
