A survey by the European Society of Breast Imaging on the implementation of breast diffusion-weighted imaging in clinical practice

Objectives To perform a survey among all European Society of Breast Imaging (EUSOBI) radiologist members to gather representative data regarding the clinical use of breast DWI. Methods An online questionnaire was developed by two board-certified radiologists, reviewed by the EUSOBI board and committees, and finally distributed among EUSOBI active and associated (not based in Europe) radiologist members. The questionnaire included 20 questions pertaining to technical preferences (acquisition time, magnet strength, breast coils, number of b values), clinical indications, imaging evaluation, and reporting. Data were analyzed using descriptive statistics, the Chi-square test of independence, and Fisher's exact test. Results Of 1411 EUSOBI radiologist members, 275/1411 (19.5%) responded. Most (222/275, 81%) reported using DWI as part of their routine protocol. Common indications for DWI include lesion characterization (using an ADC threshold of 1.2-1.3 x 10(-3) mm(2)/s) and prediction of response to chemotherapy. Members most commonly acquire two separate b values (114/217, 53%), with b value = 800 s/mm(2) being the preferred value for appraisal among those acquiring more than two b values (71/171, 42%). Most did not use synthetic b values (169/217, 78%). While most mention hindered diffusion in the MRI report (161/213, 76%), only 142/217 (57%) report ADC values. Conclusion The utilization of DWI in clinical practice among EUSOBI radiologists who responded to the survey is generally in line with international recommendations, with the main application being the differentiation of benign and malignant enhancing lesions, treatment response assessment, and prediction of response to chemotherapy. Report integration of qualitative and quantitative DWI data is not uniform.

Automated summary

This study surveyed European Society of Breast Imaging (EUSOBI) radiologist members to gather data on the clinical use of breast DWI. The results showed that most radiologists use DWI as part of their routine protocol, mainly for lesion characterization and prediction of chemotherapy response. The majority of radiologists use two separate b values and prefer an appraisal value of 800 s/mm(2). Synthetic b values are not commonly used and report integration of qualitative and quantitative DWI data is inconsistent.