Contrast agent-free breast MRI. Advantages and potential disadvantages

BackgroundContrast-enhanced breast magnetic resonance imaging (MRI) is the most sensitive method for detection of breast cancer. The further spread of breast MRI is limited by the complicated examination procedure and the need for intravenously administered contrast media.ObjectivesCan diffusion-weighted imaging (DWI) replace contrast-enhanced sequences to achieve an unenhanced breast MRI examination?Materials and methodsNarrative review and meta-analytic assessment of previously published studies.ResultsDWI can visualize breast lesions and distinguish benign from malignant findings. It is thus avalid alternative to contrast-enhanced sequences. As an additional technique, the use of DWI can reduce the numbers of unnecessary breast biopsies. The lack of robustness leading to variable sensitivity that is currently lower than that of contrast-enhanced breast MRI is adisadvantage of DWI.ConclusionsPresently, DWI can be recommended as an integral part of clinical breast MRI protocols. The application as astand-alone technique within unenhanced protocols is still under evaluation.