Breast MRI during lactation: effects on tumor conspicuity using dynamic contrast-enhanced (DCE) in comparison with...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Lactation can alter breast tissue characteristics, potentially affecting cancer detection.
• Pregnancy-associated breast cancer (PABC) presents unique diagnostic challenges.
• Dynamic contrast-enhanced (DCE) MRI is a key imaging modality for breast cancer detection.

Purpose of the Study:

• To compare breast cancer conspicuity on DCE MRI during lactation versus non-lactation.
• To evaluate the utility of diffusion tensor imaging (DTI) parametric maps in lactating patients with PABC.
• To assess if DTI can enhance tumor visualization when DCE MRI conspicuity is reduced.

Main Methods:

• Prospective evaluation of 11 lactating patients with PABC using DCE and DTI MRI.
• Retrospective review of DCE MRI from 16 non-lactating breast cancer patients as controls.
• Analysis of contrast-to-noise ratio (CNR) and DTI parameters (λ1, λ2, λ3, MD, FA) to assess tumor conspicuity.

Main Results:

• Breast cancer conspicuity on DCE MRI was significantly reduced (58-62%) in lactating patients compared to non-lactating controls.
• DTI parameters (λ1, λ2, λ3, MD) were decreased, and FA increased in PABC lesions within lactating patients.
• DTI parametric maps showed significantly superior CNR compared to DCE MRI in lactating patients, improving tumor conspicuity by up to 138%.

Conclusions:

• Lactation markedly reduces breast cancer conspicuity on DCE MRI due to increased background parenchymal enhancement.
• Diffusion tensor imaging (DTI) can significantly improve the visualization and quantitative characterization of PABC in lactating women.
• The combined use of DCE MRI and DTI may offer additive value in the diagnostic workup of PABC.