Additional value of diffusion-weighted imaging to evaluate multifocal and multicentric breast cancer detected using pre-operative breast MRI.
Objectives: 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.Methods: DCE-MRI and DWI were performed on 131 lesions, with available histopathological resu...
| Publicado en: | European Radiology Vol. 27; no. 11; pp. 4819 - 4828 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Nov2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125580621&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125580621 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Nov2017 vid: 27 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 125580621 125580621 144103497 NLM28593433 10.1007/s00330-017-4898-5 NLM28593433 125580621 ppf: 4819 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Additional value of diffusion-weighted imaging to evaluate multifocal and multicentric breast cancer detected using pre-operative breast MRI. aug: au: 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 affil: Department of Radiology , Korea University Anam Hospital, Korea University College of Medicine , 73, Inchon-ro, Seongbuk-gu Seoul 02841 Korea sug: subj: Magnetic Resonance Imaging Magnetic Resonance Imaging Methods Breast Neoplasms Breast Neoplasms Pathology Preoperative Care Prospective Studies Breast Sensitivity and Specificity Biopsy Adult Middle Age Breast Pathology Contrast Media Female Aged Unnecessary Procedures Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Female ab: Objectives: 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.Methods: 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.Results: 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.Conclusions: 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.Key Points: • 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. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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