Breast Cancer Research and Treatment

, Volume 177, Issue 3, pp 629–639 | Cite as

Non-contrast MRI for breast screening: preliminary study on detectability of benign and malignant lesions in women with dense breasts

  • Yangyang Bu
  • Jun Xia
  • Bobby Joseph
  • Xianjing Zhao
  • Maosheng Xu
  • Yingxing Yu
  • Shouliang Qi
  • Kamran A. Shah
  • Shiwei WangEmail author
  • Jiani HuEmail author
Preclinical study



The importance of breast cancer screening has long been known. Unfortunately, there is no imaging modality for screening women with dense breasts that is both sensitive and without concerns regarding potential side effects. The purpose of this study is to explore the possibility of combined diffusion-weighted imaging and turbo inversion recovery magnitude MRI (DWI + TIRM) to overcome the difficulty of detection sensitivity and safety.


One hundred and seventy-six breast lesions from 166 women with dense breasts were retrospectively evaluated. The lesion visibility, area under the curve (AUC), sensitivity and specificity of cancer detection by MG, DWI + TIRM, and clinical MRI were evaluated and compared. MG plus clinical MRI served as the gold standard for lesion detection and pathology served as the gold standard for cancer detection.


Lesion visibility of DWI + TIRM (96.6%) was significantly superior to MG (67.6%) in women with dense breasts (p < 0.001). There was no significant difference compared with clinical MRI. DWI + TIRM showed higher accuracy (AUC = 0.935) and sensitivity (93.68%) for breast cancer detection than MG (AUC = 0.783, sensitivity = 46.32%), but was comparable to clinical MRI (AUC = 0.944, sensitivity = 93.68%). The specificity of DWI + TIRM (83.95%) was lower than MG (98.77%), but higher than clinical MRI (77.78%).


DWI combined with TIRM could be a safe, sensitive, and practical alternative for screening women with dense breasts.


Dense breasts Non-contrast MRI Diffusion-weighted imaging Mammography Breast cancer screening 



Apparent diffusion coefficient


Area under the curve


Breast imaging reporting and data system




Diffusion-weighted imaging


Diffusion-weighted and turbo inversion recovery magnitude MRI




Mediolateral oblique


Magnetic resonance imaging


Picture archiving and communications system


Receiver operating characteristic


Region of interest


Short time inversion recovery


Turbo inversion recovery magnitude


Author contributions

XZ, JW, SW, and JH conceived and designed the study. SW, MX, YY, and YB enrolled the patients eligible for the study. XZ, MX, YY, and YB performed the analysis and interpretation of data. XZ, JW, YB, and SW drafted the manuscript. JH, BJ, AZ, and KS revised the manuscript critically. All authors read and approved the final manuscript.


This work was supported by the Chinese medicine research foundation project of Zhejiang Province (Grant Number 2018ZA037); Zhejiang provincial medicine and health discipline platform project (Grant Number 2018RC058); Zhejiang provincial health department platform backbone project (Grant Number 2016147237).

Compliance with ethical standards

Conflict of interest

This work is supported in part by research grants from Chinese medicine research foundation project of Zhejiang Province, Zhejiang provincial medicine and health discipline platform project, and Zhejiang provincial health department platform backbone project.

Ethical approval

The institutional review board of the 1st Affiliated Hospital of Zhejiang Chinese Medical University approved the protocol (2018-KL-017-01).


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019
corrected publication 2019

Authors and Affiliations

  1. 1.The First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
  2. 2.Department of RadiologyThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
  3. 3.Department of RadiologyThe First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s HospitalShenzhenChina
  4. 4.Department of RadiologyWayne State UniversityDetroitUSA
  5. 5.Sino-Dutch Biomedical and Information Engineering School of Northeastern UniversityShenyangChina

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