{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T06:11:47Z","timestamp":1776406307798,"version":"3.51.2"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The primary aim of this study was to explore whether intravoxel incoherent motion (IVIM) can offer a contrast-agent-free alternative to dynamic contrast-enhanced (DCE)-MRI for measuring breast tumor perfusion. The secondary aim was to investigate the relationship between tissue diffusion measures from DWI and DCE-MRI measures of the tissue interstitial and extracellular volume fractions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A total of 108 paired DWI and DCE-MRI scans were acquired at 1.5 T from 40 patients with primary breast cancer (median age: 44.5 years) before and during neoadjuvant chemotherapy (NACT). DWI parameters included apparent diffusion coefficient (ADC), tissue diffusion (D<jats:sub>t<\/jats:sub>), pseudo-diffusion coefficient (D<jats:sub>p<\/jats:sub>), perfused fraction (f), and the product f\u00d7D<jats:sub>p<\/jats:sub> (microvascular blood flow). DCE-MRI parameters included blood flow (F<jats:sub>b<\/jats:sub>), blood volume fraction (v<jats:sub>b<\/jats:sub>), interstitial volume fraction (v<jats:sub>e<\/jats:sub>) and extracellular volume fraction (v<jats:sub>d<\/jats:sub>). All were extracted from three tumor regions of interest (whole-tumor, ADC cold-spot, and DCE-MRI hot-spot) at three MRI visits: pre-treatment, after one, and three cycles of NACT. Spearman\u2019s rank correlation was used for assessing between-subject correlations (r), while repeated measures correlation was employed to assess within-subject correlations (r<jats:sub>rm<\/jats:sub>) across visits between DWI and DCE-MRI parameters in each region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No statistically significant between-subject or within-subject correlation was found between the perfusion parameters estimated by IVIM and DCE-MRI (f versus v<jats:sub>b<\/jats:sub> and f\u00d7D<jats:sub>p<\/jats:sub> versus F<jats:sub>b<\/jats:sub>; P=0.07\u20130.81). Significant moderate positive between-subject and within-subject correlations were observed between ADC and v<jats:sub>e<\/jats:sub> (r=0.461, r<jats:sub>rm<\/jats:sub>=0.597) and between D<jats:sub>t<\/jats:sub> and v<jats:sub>e<\/jats:sub> (r=0.405, r<jats:sub>rm<\/jats:sub>=0.514) as well as moderate positive within-subject correlations between ADC and v<jats:sub>d<\/jats:sub> and between D<jats:sub>t<\/jats:sub> and v<jats:sub>d<\/jats:sub> (r<jats:sub>rm<\/jats:sub>=0.619 and 0.564, respectively) in the whole-tumor region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No correlations were observed between the perfusion parameters estimated by IVIM and DCE-MRI. This may be attributed to imprecise estimates of fxD<jats:sub>p<\/jats:sub> and v<jats:sub>b<\/jats:sub>, or an underlying difference in what IVIM and DCE-MRI measure. Care should be taken when interpreting the IVIM parameters (f and f\u00d7D<jats:sub>p<\/jats:sub>) as surrogates for those measured using DCE-MRI. However, the moderate positive correlations found between ADC and D<jats:sub>t<\/jats:sub> and the DCE-MRI parameters v<jats:sub>e<\/jats:sub> and v<jats:sub>d<\/jats:sub> confirms the expectation that as the interstitial and extracellular volume fractions increase, water diffusion increases.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1356173","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T04:47:53Z","timestamp":1716353273000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The relationship between parameters measured using intravoxel incoherent motion and dynamic contrast-enhanced MRI in patients with breast cancer undergoing neoadjuvant chemotherapy: a longitudinal cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Zyad M.","family":"Almutlaq","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah 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