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Background Breast Parenchymal Signal During Menstrual Cycle on Diffusion-Weighted MRI: A Prospective Study in Healthy Premenopausal Women

  • Yeon Soo Kim (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Bo La Yun (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • A Jung Chu (Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine) ;
  • Su Hyun Lee (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Hee Jung Shin (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sun Mi Kim (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Mijung Jang (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Sung Ui Shin (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Woo Kyung Moon (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2024.03.31
  • Accepted : 2024.04.05
  • Published : 2024.06.01

Abstract

Objective: To prospectively investigate the influence of the menstrual cycle on the background parenchymal signal (BPS) and apparent diffusion coefficient (ADC) of the breast on diffusion-weighted MRI (DW-MRI) in healthy premenopausal women. Materials and Methods: Seven healthy premenopausal women (median age, 37 years; range, 33-49 years) with regular menstrual cycles participated in this study. DW-MRI was performed during each of the four phases of the menstrual cycle (four examinations in total). Three radiologists independently assessed the BPS visual grade on images with b-values of 800 sec/mm2 (b800), 1200 sec/mm2 (b1200), and a synthetic 1500 sec/mm2 (sb1500). Additionally, one radiologist conducted a quantitative analysis to measure the BPS volume (%) and ADC values of the BPS (ADCBPS) and fibroglandular tissue (ADCFGT). Changes in the visual grade, BPS volume (%), ADCBPS, and ADCFGT during the menstrual cycle were descriptively analyzed. Results: The visual grade of BPS in seven women varied from mild to marked on b800 and from minimal to moderate on b1200 and sb1500. As the b-value increased, the visual grade of BPS decreased. On b800 and sb1500, two of the seven volunteers showed the highest visual grade in the early follicular phase (EFP). On b1200, three of the seven volunteers showed the highest visual grades in EFP. The BPS volume (%) on b800 and b1200 showed the highest value in three of the six volunteers with dense breasts in EFP. Three of the seven volunteers showed the lowest ADCBPS in the EFP. Four of the seven volunteers showed the highest ADCBPS in the early luteal phase (ELP) and the lowest ADCFGT in the late follicular phase (LFP). Conclusion: Most volunteers did not exhibit specific BPS patterns during their menstrual cycles. However, the highest BPS and lowest ADCBPS were more frequently observed in EFP than in the other menstrual cycle phases, whereas the highest ADCBPS was more common in ELP. The lowest ADCFGT was more frequent in LFP.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2019R1F1A1062646) and Research Program 2021 funded by Seoul National University College of Medicine Research Foundation.

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