"An MRI breast imaging technique that requires no contrast agent combined with sophisticated data analysis could reduce the number of unnecessary breast biopsies according to a new study appearing online in the journal Radiology.  Breast MRI currently is used to screen women at high risk of breast cancer and as a diagnostic adjunct to mammography. The examination relies on gadoliniumbased contrast agents that need to be injected intravenously. Researchers recently studied an alternative approach that eliminates the need for contrast agents in some cases by using diffusionweighted imaging DWI measurements derived from MRI. The technique known as diffusion kurtosis imaging provides a picture of breast tissue on a microstructural level.  Diffusion kurtosis imaging has been introduced in DWI to provide important information on tissue structures at a microscopic level said study lead author Sebastian Bickelhaupt M.D. from the German Cancer Research Center in Heidelberg Germany. Since malignant lesions disrupt the tissue structures at this level diffusion kurtosis might serve as a relevant marker of changes. Dr. Bickelhaupt colead author Paul Jaeger M.Sc. and colleagues evaluated a retrospective analysis of data collected from  women at two independent study sites. The women had suspicious findings on mammography that were classified under the Breast Imaging Reporting and Data System BIRADS as BIRADS  and  breast lesions. A BIRADS  lesion is considered a suspicious abnormality while a  is considered highly suspicious of malignancy. The women underwent DWI followed by biopsy. For the analysis a software algorithm was developed for lesion characterization and imaging features were extracted using a kurtosisbased radiomics model. Radiomics is a rapidly growing field that enables the extraction of a large amount of quantifiable data from images.  In an independent test set of  women the radiomics analysis reduced falsepositive findings by  percent while detecting  of  malignant lesions or  percent.  The model might help to lower the number of BIRADS  lesions suspected of being cancer on the basis of screening mammography while retaining a high sensitivity similar to the sensitivity reported for biopsies themselves Jaeger said.  Should the results hold in larger trials the model has potential advantages in the clinic beyond its ability to reduce unnecessary biopsies in women with BIRADS  lesions. The software algorithm makes the assessment readerindependent ensuring that its accuracy is maintained across different imaging facilities.  The new approach is not intended to replace current contrastenhanced breast MRI protocols in general Dr. Bickelhaupt emphasized but to expand the spectrum of options available for answering specific clinical questions.  This might also improve the efficiency of reporting he said.   Radiomics Based on Adapted Diffusion Kurtosis Imaging Helps to Clarify Most Mammographic Findings Suspicious for Cancer. Collaborating with Dr. Bickelhaupt and Jaeger were Frederik Bernd Laun Prof. Dr. Wolfgang Lederer M.D. Heidi Daniel M.D. Tristan Anselm Kuder Dr. rer nat Lorenz Wuesthof Daniel Paech M.D. David Bonekamp M.D. Alexander Radbruch M.D. Stefan Delorme Prof. Dr. HeinzPeter Schlemmer Prof. Dr. Franziska Steudle and Klaus H. MaierHein Ph.D. Radiology is edited by David A. Bluemke M.D. Ph.D. University of Wisconsin School of Medicine and Public Health Madison Wis. and owned and published by the Radiological Society of North America Inc. httpRSNA.orgradiology RSNA is an association of over  radiologists radiation oncologists medical physicists and related scientists promoting excellence in patient care and health care delivery through education research and technologic innovation. The Society is based in Oak Brook Ill. RSNA.org http For patientfriendly information on breast MRI visit RadiologyInfo.org http"