Introduction: Breast cancer diagnosis in pregnant and lactating women is often delayed because of masking physiological modifications. MRI using contrast agent is the most sensitive modality for early diagnosis of breast cancer, however, it is contra-indicated during pregnancy and its utility is diminished during lactation. Alternatively, diffusion tensor imaging (DTI) of the breast, an unenhanced MRI technique that was recently developed at the Weizmann Institute of Science, might be suitable for this unique population.
Aims: To study the feasibility and clinical utility of breast DTI among pregnant or lactating patients.
Methods: A pilot study based on a multi-center collaboration, initiated to scan pregnant women with breast DTI alone and DTI in addition to contrast enhanced MRI took place recently in the Sheba Medical Center.
Results: Initial observations among pregnant patients suggest that DTI is highly tolerated and has high diagnostic accuracy among breast cancer patients and high risk patients. Among lactating patients, DTI enabled increased tumor conspicuity as compared with the conventional contrasted enhanced MRI method.
Conclusions: DTI breast examination has the potential to serve as a standalone modality during pregnancy and as a valuable adjunct tool during lactation. Further technical development is required for implementing it in the general population.