Characterization of malignant breast tissue of breast cancer patients and the normal breast tissue of healthy lactating women volunteers using diffusion MRI and in vivo ¹H MR spectroscopy

Purpose: To investigate the potential of diffusion weighted imaging (DWI) and in vivo proton MR spectroscopy (MRS) in the differentiation of breast tissue of healthy lactating women volunteers and breast cancer patients. Materials and Methods: DWI and MRS were carried out at 1.5 Tesla on 12 breast cancer patients and 12 normal lactating women volunteers. Apparent diffusion coefficient (ADC) and total choline (tCho) concentration were determined. Results: tCho was observed in all breast cancer patients and in 10/12 lactating women. Additionally a peak at 3.8 ppm corresponding to lactose was seen in 10/12 of lactating women. Concentration of tCho was similar in malignant breast tissue of patients (3.51 ± 1.72 mmol/kg) and in normal breast tissue of lactating women (3.52 ± 1.70 mmol/kg). However, ADC was significantly higher in the normal breast tissue of lactating women (1.62 ± 0.22 × 10⁻³ mm²/s) compared with the malignant breast tissue of patients (1.01 ± 0.10 × 10⁻³ mm²/s). Conclusion: Observation of lactose peak with higher ADC in the breast tissue of healthy lactating women volunteers may aid in differentiation of changes that occur in breast tissue due to normal physiological conditions like lactation compared with malignant transformation