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. 2011 May;65(5):1437-47.
doi: 10.1002/mrm.22740. Epub 2011 Feb 1.

Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer

E E Sigmund  1 , G Y Cho, S Kim, M Finn, M Moccaldi, J H Jensen, D K Sodickson, J D Goldberg, S Formenti, L Moy
Affiliations

Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer

E E Sigmund et al. Magn Reson Med. 2011 May.

Abstract

Diffusion-weighted imaging plays important roles in cancer diagnosis, monitoring, and treatment. Although most applications measure restricted diffusion by tumor cellularity, diffusion-weighted imaging is also sensitive to vascularity through the intravoxel incoherent motion effect. Hypervascularity can confound apparent diffusion coefficient measurements in breast cancer. We acquired multiple b-value diffusion-weighted imaging at 3 T in a cohort of breast cancer patients and performed biexponential intravoxel incoherent motion analysis to extract tissue diffusivity (D(t)), perfusion fraction (f(p)), and pseudodiffusivity (D(p)). Results indicated significant differences between normal fibroglandular tissue and malignant lesions in apparent diffusion coefficient mean (±standard deviation) values (2.44 ± 0.30 vs. 1.34 ± 0.39 μm(2)/msec, P < 0.01) and D(t) (2.36 ± 0.38 vs. 1.15 ± 0.35 μm(2)/msec, P < 0.01). Lesion diffusion-weighted imaging signals demonstrated biexponential character in comparison to monoexponential normal tissue. There is some differentiation of lesion subtypes (invasive ductal carcinoma vs. other malignant lesions) with f(p) (10.5 ± 5.0% vs. 6.9 ± 2.9%, P = 0.06), but less so with D(t) (1.14 ± 0.32 μm(2)/msec vs. 1.18 ± 0.52 μm(2)/msec, P = 0.88) and D(p) (14.9 ± 11.4 μm(2)/msec vs. 16.1 ± 5.7 μm(2)/msec, P = 0.75). Comparison of intravoxel incoherent motion biomarkers with contrast enhancement suggests moderate correlations. These results suggest the potential of intravoxel incoherent motion vascular and cellular biomarkers for initial grading, progression monitoring, or treatment assessment of breast tumors.

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Figures

Figure 1
Figure 1
Single shot turbo spin echo (TSE) – DWI sequence with twice refocused bipolar gradient diffusion preparation.
Figure 2
Figure 2
Sagittal anatomical images of breast lesion (red circle) before and after contrast administration. (a) Pre-contrast T1 VIBE. (b) Post-contrast T2-weighted fat-saturated image. (c) Pre-contrast T1-weighted fat-saturated image. (d) Post-contrast T1-weighted fat-saturated image.
Figure 3
Figure 3
Breast cancer (LABC) IVIM-MRI results at 3 T. (a) Gd-DTPA contrast enhanced T1-weighted axial image showing left breast invasive ductal carcinoma (IDC) lesion (red circles). (b) Unweighted ( b= 0) axial DWI and regions of interest for normal tissue (green) and lesion (red). (c) Axial DWI, b = 800 s/mm2, where lesion appears hyperintense due to cellularity-induced restricted diffusion. (d) ADC map showing lower apparent diffusion in lesion area.(e) Relative contrast enhancement curves for normal fibroglandular tissue and mass region. (f) DWI signal intensity decays for normal FG tissue and mass region. The mass region demonstrates both restricted diffusion and fast vascular pseudodiffusion.
Figure 4
Figure 4
Example results from several patients in this study. (a) DCIS lesion; (b)-(e) IDC lesions. From left to right: Post-contrast T1 images showing lesion location (red arrowheads); DWI unweighted (b0) images in which lesion is also hyperintense; ADC map showing lower values in lesions than in FG tissue; DWI signal intensity profiles from the lesion area and normal tissue. The enlarged scale view highlights the nonexponential response of the lesion tissue in comparison with the monoexponential behavior of FG tissue.
Figure 5
Figure 5
Correlation of fp with CE-MRI initial enhancement. The correlation coefficient amongst all lesions (solid line) is r = 0.42.
Figure 6
Figure 6
(a) Contrast-enhanced MRI of a breast tumor. (b) DWI unweighted image (b0) and IVIM parametric maps of fp, Dp, and Dt. (c) Two-dimensional histogram cross-correlations between IVIM parameters (fp, Dp, and Dt) in tumor regions from whole-breast acquisition. The slight negative correlation observed between perfusion fraction (fp) and the diffusivities Dp and Dt is consistent with a typical tumor microenvironment, in which abundant angiogenic neovascularity (high fp) with sluggish flow (low Dp) occurs in tandem with proliferating cellularity (low Dt).
Figure 7
Figure 7
Breast patient group analysis for IVIM parameters (a) ADC and Dt, (b) fp, and (c) Dp. FGT = normal fibroglandular tissue, IDC = invasive ductal carcinoma, OT = other malignant lesions.
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References

    1. Jellison BJ, Field AS, Medow J, Lazar M, Salamat MS, Alexander AL. Diffusion Tensor Imaging of Cerebral White Matter: A Pictorial Review of Physics, Fiber Tract Anatomy, and Tumor Imaging Patterns. AJNR Am J Neuroradiol. 2004;25(3):356–369. - PMC - PubMed
    1. Yamada I, Aung W, Himeno Y, Nakagawa T, Shibuya H. Diffusion Coefficients in Abdominal Organs and Hepatic Lesions: Evaluation with Intravoxel Incoherent Motion Echo-planar MR Imaging. Radiology. 1999;210(3):617–623. - PubMed
    1. Squillaci E, Manenti G, Cova M, Di Roma M, Miano R, Palmieri G, Simonetti G. Correlation of diffusion-weighted MR imaging with cellularity of renal tumours. Anticancer Research. 2004;24(6):4175–4179. - PubMed
    1. McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA. Diffusion-weighted MRI in cervical cancer. European Radiology. 2008;18(5):1058–1064. - PubMed
    1. Sinha S, Sinha U. Functional magnetic resonance of human breast tumors - Diffusion and perfusion imaging. Techniques in Bioinformatics and Medical Informatics. 2002;980:95–115. - PubMed

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