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Diffusion-weighted MR imaging increases diagnostic accuracy of breast MR imaging for predicting axillary metastases in breast cancer patients.
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- Author(s): Guvenc I;Guvenc I;Guvenc I; Whitman GJ; Whitman GJ; Liu P; Liu P; Yalniz C; Yalniz C; Ma J; Ma J; Dogan BE; Dogan BE; Dogan BE
- Source:
The breast journal [Breast J] 2019 Jan; Vol. 25 (1), pp. 47-55. Date of Electronic Publication: 2018 Nov 16.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Wiley Country of Publication: United States NLM ID: 9505539 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4741 (Electronic) Linking ISSN: 1075122X NLM ISO Abbreviation: Breast J Subsets: MEDLINE
- Publication Information: Publication: 2022- : [Hoboken, New Jersey] : [London] : Hindawi Wiley ;
Original Publication: Cambridge, MA : Blackwell Science, c1995- - Subject Terms: Breast Neoplasms/*diagnostic imaging ; Breast Neoplasms/*pathology ; Diffusion Magnetic Resonance Imaging/*methods ; Lymph Nodes/*diagnostic imaging; Axilla/diagnostic imaging ; Axilla/pathology ; Breast Neoplasms/surgery ; Female ; Humans ; Lymph Nodes/pathology ; Lymphatic Metastasis/diagnostic imaging ; Lymphatic Metastasis/pathology ; Magnetic Resonance Imaging/methods ; Middle Aged ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity
- Abstract: Purpose: To evaluate the incremental value of diffusion-weighted imaging (DWI) to conventional MR imaging (CMRI) to predict ipsilateral metastatic axillary lymphadenopathy in patients with newly diagnosed breast cancer.
Subjects and Methods: In an IRB approved retrospective single-institution study, newly diagnosed consecutive breast cancer patients with pathological verification of axillary lymph node (LN) status who had undergone breast MR imaging, including DWI as part of their standard MRI between August 1, 2010, and December 31, 2010, were reviewed. Lesion size, tumor grade, and tissue prognostic factors were noted. Ipsilateral axillary LNs were evaluated using morphological criteria on CMRI. Apparent diffusion coefficient (ADC) values of suspicious ipsilateral LNs were obtained and compared with ADC values of contralateral benign axillary LNs. Receiver operating characteristic curves and multivariate logistic regression analyses were used using pathology as the gold standard.
Results: Eighty-five eligible patients were identified, with surgical pathology revealing 34 patients (40%) who had malignant and 51 (60%) had benign ipsilateral axillae. The sensitivity of CMRI was 79%, with a specificity of 81%, a positive predictive value (PPV) of 65%, and a negative predictive value (NPV) of 89%. On DWI, the mean ADC value was significantly lower for metastatic LNs (0.89 ± 0.18 × 10 -3 mm 2 /s) than for benign ipsilateral LNs (1.41 ± 0.21 × 10 -3 mm 2 /s; P < 0.0001). Using a cutoff ADC value of 0.985 × 10 -3 mm 2 /s, yielded improved sensitivity, specificity, PPV, and NPV of 83%, 98%, 95%, and 93%, respectively.
Conclusion: Apparent diffusion coefficient values increase the specificity of CMRI for predicting ipsilateral axillary LN metastases in patients with newly diagnosed breast cancer.
(© 2018 Wiley Periodicals, Inc.) - Grant Information: P30CA106672 International MD Anderson Cancer Center
- Publication Date: Date Created: 20181117 Date Completed: 20190913 Latest Revision: 20190913
- Publication Date: 20240105
- Accession Number: 10.1111/tbj.13151
- Accession Number: 30444286
- Source:
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