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Updated: Mar 26, 2026
Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
[Selected clinically established and scientific techniques of diffusion-weighted MRI. In the context of imaging in
M T Freitag1, S Bickelhaupt2, C Ziener2
1Abteilung für Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland. m.freitag@dkfz.de.
Background:
Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) technique that was established in the clinical routine primarily for the detection of brain ischemia. In the past 15 years its clinical use has been extended to oncological radiology, as tumor and metastases can be depicted in DWI due to their hypercellular nature.
Principles:
The basis of DWI is the Stejskal-Tanner experiment. The diffusion properties of tissue can be visualized after acquisition of at least two diffusion-weighted series using echo planar imaging and a specific sequence of gradient pulses.
Clinical Applications:
The use of DWI in prostate MRI was reported to be one of the first established applications that found its way into internationally recognized clinical guidelines of the European Society of Urological Radiology (ESUR) and the prostate imaging reporting and data system (PI-RADS) scale. Due to recently reported high specificity and negative predictive values of 94% and 92%, respectively, its regular use for breast MRI is expected in the near future. Furthermore, DWI can also reliably be used for whole-body imaging in patients with multiple myeloma or for measuring the extent of bone metastases.
Outlook:
New techniques in DWI, such as intravoxel incoherent motion imaging, diffusion kurtosis imaging and histogram-based analyses represent promising approaches to achieve a more quantitative evaluation for tumor detection and therapy response.
Insights
Diffusion-weighted imaging (DWI), a magnetic resonance imaging (MRI) technique, is increasingly used in oncology for tumor detection. Advanced DWI methods offer quantitative evaluation for tumor detection and therapy response.
Area of Science:
- Magnetic Resonance Imaging (MRI)
- Oncological Radiology
- Biomedical Engineering
Background:
- Diffusion-weighted imaging (DWI) is an MRI technique initially used for brain ischemia detection.
- DWI is now widely applied in oncological radiology for visualizing tumors and metastases due to their hypercellularity.
Purpose of the Study:
- To review the established and emerging applications of Diffusion-weighted imaging (DWI) in clinical radiology.
- To highlight the utility of DWI in oncological imaging, including prostate, breast, and whole-body applications.
- To discuss novel DWI techniques for quantitative tumor assessment and therapy response monitoring.
Main Methods:
- DWI utilizes the Stejskal-Tanner experiment with echo planar imaging and gradient pulses.
- Acquisition of at least two diffusion-weighted series visualizes tissue diffusion properties.
- Application of DWI in prostate MRI is established in clinical guidelines (ESUR, PI-RADS).
Main Results:
- DWI demonstrates high specificity (94%) and negative predictive value (92%) in breast MRI, suggesting future regular use.
- DWI is effective for whole-body imaging in multiple myeloma and assessing bone metastases extent.
- Established clinical applications include prostate MRI, with emerging potential in breast MRI.
Conclusions:
- New DWI techniques like intravoxel incoherent motion imaging and diffusion kurtosis imaging show promise.
- These advanced methods enable more quantitative evaluation for tumor detection.
- DWI plays a crucial role in assessing therapy response.
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