We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Additional value of diffusion-weighted imaging to evaluate multifocal and multicentric breast cancer detected using pre-operative breast MRI.
- Authors
Song, Sung; Park, Eun; Cho, Kyu; Seo, Bo; Woo, Ok; Jung, Seung; Cho, Sung; Song, Sung Eun; Park, Eun Kyung; Cho, Kyu Ran; Seo, Bo Kyoung; Woo, Ok Hee; Jung, Seung Pil; Cho, Sung Bum
- Abstract
<bold>Objectives: </bold>To investigate whether diffusion-weighted imaging (DWI) aids pre-operative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate additional lesions in breast cancer patients.<bold>Methods: </bold>DCE-MRI and DWI were performed on 131 lesions, with available histopathological results. The apparent diffusion coefficient (ADC) of each lesion was measured, and the cut-off value for differentiation between malignant and benign lesions was calculated. A protocol combining the ADC cut-off value with DCE-MRI was validated in a cohort of 107 lesions in 77 patients.<bold>Results: </bold>When an ADC cut-off value of 1.11 × 10-3 mm2/s from the development cohort was applied to the additional lesions in the validation cohort, the specificity increased from 18.9% to 67.6% (P < 0.001), and the diagnostic accuracy increased from 61.7% to 82.2% (P = 0.05), without significant loss of sensitivity (98.6% vs. 90.0%, P = 0.07). The negative predictive values of lesions in the same quadrant had decreased, as had those of lesions ≥1 cm in diameter. The ADC cut-off value in the validation cohort was 1.05 × 10-3 mm2/s.<bold>Conclusions: </bold>Additional implementation of DWI for breast lesions in pre-operative MRI can help to obviate unnecessary biopsies by increasing specificity. However, to avoid missing cancers, clinicians should closely monitor lesions located in the same quadrant or lesions ≥1 cm.<bold>Key Points: </bold>• DWI can be used to further differentiate lesions during pre-operative cancer staging. • ADC cut-off values were similar in the development and validation cohorts. • DWI improves both PPV and NPV in cases of multicentric lesions. • DWI improves both PPV and NPV in lesions <1 in diameter. • NPVs are decreased in multifocal lesions and lesions ≥1 cm in diameter.
- Subjects
DIFFUSION magnetic resonance imaging; BREAST cancer diagnosis; CONTRAST-enhanced magnetic resonance imaging; DIFFUSION coefficients; DIAGNOSTIC errors; PREVENTION
- Publication
European Radiology, 2017, Vol 27, Issue 11, p4819
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-017-4898-5