الفهرس 
Introduction
Ch. 1 : Breast CancerOnly 14 pages are availabe for public view
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Abstract
DWIBS is an effective method for detection of solid organs, bone and lymph node metastasis but not specific for characterization of lesions. Results indicate that it shows excellent diagnostic accuracy for the detection of distant metastatic disease and represents a promising tool for tumor surveillance and screening of patient populations with suspicion of tumor recurrence, especially in tumors with frequent metastatic spread to the bone, liver or CNS. As a whole-body bone marrow screening method it is a useful tool for a precise assessment of the total skeletal status and is highly effective in staging malignant bone marrow diseases such as early bone metastasis. Therefore, patients might benefit from early accurate staging and improved therapeutic options.
It needs no ionizing radiation or contrast media and also has better spatial resolution.
DWIBS Image acquisition during free breathing, multiple signal averaging, and background body signal suppression by means of a fat suppression pre-pulse and heavy diffusion weighting, are the main features of DWIBS. DWIBS is a diffusion-weighted sequence, but its (image) characteristics are different from conventional (breathhold or respiratory triggered) DWI. DWIBS highlights areas with restricted diffusion, such as occurs in many malignant primary and metastatic tumors, Although the exact value of DWIBS still has to be established, it has potential use in tumor staging and in the detection of tumor persistence or recurrence.
ADC measurements in DWIBS signal intensity is directly related to the degree of diffusion and the ADC is the quantitative measure of diffusion in DWI. Both signal intensity and ADCs are main-stays in the identification and characterization of lesions in DWI. However, because of the allowance of respiratory motion in DWIBS, slice levels of images obtained with different p-values may not be identical. In addition, because DWIBS employs multiple slice excitations, slices levels of images obtained with the same p-value may be different. Consequently, ADC measurements of moving or-gans in DWIBS may be less accurate, less reproducible, and different from conventional (breath-hold or respiratory triggered) DWI. In other words, DWIBS images of moving organs are possibly more suitable for visual non-quantitative evaluation than quantitative analysis Also, it should be noted that the comparison between respiratory triggered DWI and DWIBS was (clinically) not fair, since roughly estimated scanning time of respiratory triggered DWI was approximately 1.3-to 2-times longer.