CHARACTERIZATION OF BREAST MASSES BY NEW MRI MODALITIES ( MR SPECTROSCOPY , MR DIFFUSION AND MR PERFUSION)

Abstract

Breast cancer is the most common malignant tumor among women, and the purpose of all diagnostic modalities in breast cancer is early detection and proper diagnosis, which has its major impact on further management and prognosis.This review describes three relatively new MR techniques as applied to breast tumor characterization: MR diffusion, MR perfusion and MR spectroscopy. The preliminary studies show that diffusion-weighted imaging of the breast is technically feasible and can help characterize breast masses by providing information not available from conventional MR images. Single shot techniques are critical to the successful clinical implementation of diffusion-weighted imaging. The studies clearly indicate that the apparent diffusion coefficient (ADC) has the potential to (1) discriminate cysts from solid tumors, (2) characterize necrotic tissue, (3) determine changes in cell density, and (4) distinguish benign from malignant breast tumors. Further work is needed to explore the full potential of diffusion imaging in tumor characterization.

As in the case of diffusion imaging, the field of perfusion MR imaging of the breast is a relatively recent development. The studies indicate the technical feasibility and the clinical utility of this type of imaging. Perfusion imaging have the potential to distinguish malignant from benign lesions due to the higher micro vascularity of malignant tumors. In case of hypo vascular tumors combined other MRI modalities will specify the lesion ,finally biopsy is the last choice otherwise.

MR Spectroscopy should be applied successfully in the breast preoperatively and noninvasively to distinguish malignancies from benign lesions and healthy tissue with a high level of accuracy.

In summary, MR perfusion imaging , MR diffusion and MR spectroscopy have been proved to be complementary tools for improving the specificity in the detection of malignant breast masses.