Background: Contrast-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.
Objectives: Can diffusion-weighted imaging (DWI) replace contrast-enhanced sequences to achieve an unenhanced breast MRI examination?
Materials and methods: Narrative review and meta-analytic assessment of previously published studies.
Results: DWI can visualize breast lesions and distinguish benign from malignant findings. It is thus a valid 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 a disadvantage of DWI.
Conclusions: Presently, DWI can be recommended as an integral part of clinical breast MRI protocols. The application as a stand-alone technique within unenhanced protocols is still under evaluation.
Keywords: Breast cancer; Diffusion-weighted imaging; Magnetic resonance imaging; Screening; Sensitivity.