Diffusion-Tensor MR Imaging of the Breast: Hormonal Regulation

Noam Nissan, Edna Furman-Haran, Myra Shapiro-Feinberg, Dov Grobgeld, Hadassa Degani

Research output: Contribution to journalArticlepeer-review

52 Citations (Scopus)

Abstract

Purpose: To investigate the parameters obtained with magnetic resonance (MR) diffusion-tensor imaging (DTI) of the breast throughout the menstrual cycle phases, during lactation, and after menopause, with and without hormone replacement therapy (HRT). Materials and Methods: All protocols were approved by the internal review board, and signed informed consent was obtained from all participants. Forty-five healthy volunteers underwent imaging by using T2-weighted and DTI MR sequences at 3 T. Premenopausal volunteers (n = 16) underwent imaging weekly, four times during one menstrual cycle. Postmenopausal volunteers (n = 19) and lactating volunteers (n = 10) underwent imaging once. The principal diffusion coefficients (lambda 1, lambda 2, and lambda 3), apparent diffusion coefficient (ADC), fractional anisotropy (FA), and maximal anisotropy (lambda 1-lambda 3) were calculated pixel by pixel for the fibroglandular tissue in the entire breast. Results: In all premenopausal volunteers, the DTI parameters exhibited high repeatability, remaining almost equal along the menstrual cycle, with a low mean within-subject coefficient of variance of lambda 1, lambda 2, lambda 3, and ADC (1%-2% for all) and FA (5%), as well as a high intraclass correlation of 0.92-0.98. The diffusion coefficients were significantly lower (a) in the group without HRT use as compared with the group with HRT use (P <.01) and premenopausal volunteers (P <.01) and (b) in the lactating volunteers as compared with the premenopausal volunteers (P <.005). No significant differences in DTI parameters were found between premenopausal volunteers free of oral contraceptives and those who used oral contraceptives (P = .28-0.82) and between premenopausal volunteers and postmenopausal volunteers who used HRT (P = .31-0.93). Conclusion: DTI parameters are not sensitive to menstrual cycle changes, while menopause, long-term HRT, and presence of milk in lactating women affected the DTI parameters. Therefore, the
Original languageEnglish
Pages (from-to)672-680
Number of pages9
JournalRadiology
Volume271
Issue number3
DOIs
Publication statusPublished - Jun 2014

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