Factors Affecting Cancer Detectability on Standalone Diffusion Weighted Imaging for Non-contrast Breast Cancer Screening

Diffusion weighted imaging (DWI) is emerging as a viable tool for non-contrast MRI breast cancer screening, but it is unclear what factors on DWI impact lesion detectability. In this prospective clinical trial, we evaluated lesion and imaging factors that affected cancer detection. Cancers were overall more detectable at higher b=1200 vs b=800 s/mm2, but the background parenchymal signal (BPS) impacted cancer visibility at the higher b value. Cancer histologic type also impacted detectability on DWI. Overall, our findings suggest that interpretation at higher b values and further technical refinements to reduce appearance of BPS may help improve DWI sensitivity.