Diffusion-weighted imaging of the breast-a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group
Diffusion-weighted imaging of the breast-a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group
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DOI：
10.1007/s00330-019-06510-3
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发表时间：
2019-11-30
影响因子：
5.9
通讯作者：
Le Bihan, Denis
中科院分区：
文献类型：
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作者：
Baltzer, Pascal;Mann, Ritse M.;Le Bihan, Denis
欧洲乳腺放射学会（EUSOBI）成立了国际乳腺DWI工作组。工作组由临床乳腺MRI专家、MRI物理学家和来自大型MRI设备供应商的代表组成，他们是根据乳腺MRI和/或特别是乳腺DWI方面的成熟专业知识邀请的，代表来自16个国家的25个研究中心。工作组的目标是：（a）通过发表共识声明和酌情启动合作研究，促进乳腺DWI在临床实践中的使用;（B）为乳腺DWI的临床应用确定必要的标准并提供实际指导;（c）制定标准化和可翻译的多中心多供应商质量保证协议，特别是针对多中心研究;（d）就图像处理/分析、可视化和解释的最佳方法达成共识;（e）与系统供应商合作，改进乳腺DWI序列。本文提出的第一个共识建议包括标准乳腺DWI序列的采集参数，包括B值、脂肪饱和度、空间分辨率以及重复和回波时间的规格。为了客观描述病变，根据已发表的乳腺DWI文献定义了乳腺扩散限制/阻碍水平。目前建议在ADC图上病变最暗部分使用小ROI，避免坏死、噪声或非增强病变体素。工作组强调，在应用ADC阈值之前，需要进行标准化和质量保证。工作组鼓励进一步研究先进的扩散技术和针对特定适应症的定制DWI策略。工作组认为乳腺DWI是多参数乳腺MRI方案的重要组成部分，并鼓励使用。center dot提供了乳腺DWI常规临床应用的基本要求，包括对B值、脂肪饱和度、空间分辨率和其他序列参数的建议。基于荟萃分析数据定义了乳腺病变的中心点扩散水平，并详细介绍了获得可靠ADC值的方法。
The European Society of Breast Radiology (EUSOBI) established an International Breast DWI working group. The working group consists of clinical breast MRI experts, MRI physicists, and representatives from large vendors of MRI equipment, invited based upon proven expertise in breast MRI and/or in particular breast DWI, representing 25 sites from 16 countries. The aims of the working group are (a) to promote the use of breast DWI into clinical practice by issuing consensus statements and initiate collaborative research where appropriate; (b) to define necessary standards and provide practical guidance for clinical application of breast DWI; (c) to develop a standardized and translatable multisite multivendor quality assurance protocol, especially for multisite research studies; (d) to find consensus on optimal methods for image processing/analysis, visualization, and interpretation; and (e) to work collaboratively with system vendors to improve breast DWI sequences. First consensus recommendations, presented in this paper, include acquisition parameters for standard breast DWI sequences including specifications of b values, fat saturation, spatial resolution, and repetition and echo times. To describe lesions in an objective way, levels of diffusion restriction/hindrance in the breast have been defined based on the published literature on breast DWI. The use of a small ROI placed on the darkest part of the lesion on the ADC map, avoiding necrotic, noisy or non-enhancing lesion voxels is currently recommended. The working group emphasizes the need for standardization and quality assurance before ADC thresholds are applied. The working group encourages further research in advanced diffusion techniques and tailored DWI strategies for specific indications. Key Points center dot The working group considers breast DWI an essential part of a multiparametric breast MRI protocol and encourages its use. center dot Basic requirements for routine clinical application of breast DWI are provided, including recommendations on b values, fat saturation, spatial resolution, and other sequence parameters. center dot Diffusion levels in breast lesions are defined based on meta-analysis data and methods to obtain a reliable ADC value are detailed.