Multiparametric magnetic resonance imaging of the breast : What can we expect from the future?

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The combination of different MRI methods is described as multiparametric MRI (mpMRI) and plays asignificant role in breast cancer diagnostics. Currently, mpMRI includes contrast-enhanced and diffusion-weighted MRI. For amore comprehensive characterization of the key processes involved in cancer development, additional MRI methods that capture functional processes at the cellular and molecular levels are necessary. In the context of preclinical studies, MRI methods that enable contrast-free evaluation of key processes at the metabolic and molecular levels are being developed for future clinical applications. What does multiparametric MRI in breast cancer look like in the future? Systematic literature analysis focusing on preclinical research with regard to mpMRI as well as development and modification of noninvasive MRI methods. Some of the most promising MRI methods for the evaluation of breast cancer that can answer functional and metabolic questions are BOLD (blood oxygen level dependent), IVIM (intravoxel incoherent motion), DMI (deuterium metabolic imaging) and CEST (chemical exchange saturation transfer). Acombination and, therefore, amultiparametric approach allows for anoninvasive differentiation of breast cancer subtypes and early detection of treatment response which is crucial for the future development of the disease. Standardization of quantification methods as well as improvement and expansion of MRI methods enable such amultiparametric, functional, and metabolic evaluation of the tumor. Many of these are initially developed in preclinical settings before they can be translated into clinical practice.