Editorial for “Contrasts between diffusion-weighted imaging and dynamic contrast-enhanced MR in diagnosing malignancies of breast non-mass enhancement lesions based on morphologic assessment”
Abstract
Editorial for “Contrasts Between Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MR in Diagnosing Malignancies of Breast Nonmass Enhancement Lesions Based on Morphologic Assessment” It is well established that contrast-enhanced MRI provides superior sensitivity for breast cancer detection over other imaging modalities but also results in many benign biopsies. To support wider utilization of MRI for breast screening, there is great interest in strategies to improve specificity and reduce false positives. In particular, non-mass enhancement (NME) type lesions, identified on dynamic contrast-enhanced (DCE) MRI as enhancing regions lacking features of a focus or a mass, present unique diagnostic challenges. Malignant NME can be difficult to distinguish from normal background parenchymal enhancement (BPE), and DCE-MRI features overlap significantly between malignant and benign NME lesions. Biopsy of NME most often reveals benign proliferative pathologies (eg fibrocystic changes), but up to one-third are malignant, with ductal carcinoma in situ and diffuse invasive cancers (eg invasive lobular carcinoma) commonly manifesting as NME. Currently, there are no clear criteria to downgrade suspicious NMEs and obviate biopsy. Diffusion-weighted imaging (DWI) has emerged as a useful supplemental imaging technique for screening and diagnosis of breast cancer, with many studies showing malignancies exhibit hindered diffusion and lower apparent diffusion coefficient (ADC) values…
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