Magnetic Resonance Imaging: Advanced Applications in Breast Cancer

Abstract

Breast MRI is a highly sensitive imaging tool for breast cancer detection. In general clinical practice, breast MRI utilizes a limited dynamic contrast-enhanced (DCE) acquisition that provides morphologic and semi-quantitative kinetic information to allow characterization of breast findings. This approach provides sensitivities approaching 100 % for breast cancer detection; however, its specificity remains moderate due to limited ability to differentiate benign pathologic processes that enhance from malignancies. Several advanced MRI techniques, such as high-temporal resolution DCE that allows robust quantitative pharmacokinetic analysis, diffusion-weighted imaging that allows microstructural characterization, and MR spectroscopy that reflects chemical composition, hold promise to improve standard breast MRI specificity and to serve as imaging biomarkers that can guide treatment decisions. In this review article, we review recent updates in advanced breast MRI applications, including their potential clinical uses and challenges to implementation.