Additional value of diffusion-weighted imaging to evaluate multifocal and multicentric breast cancer detected using pre-operative breast MRI
- Authors
- Song, Sung Eun; Park, Eun Kyung; Cho, Kyu Ran; Seo, Bo Kyoung; Woo, Ok Hee; Jung, Seung Pil; Cho, Sung Bum
- Issue Date
- Nov-2017
- Publisher
- SPRINGER
- Keywords
- Breast neoplasm; Diffusion-weighted imaging; Breast magnetic resonance imaging; Apparent diffusion coefficient; Staging
- Citation
- EUROPEAN RADIOLOGY, v.27, no.11, pp 4819 - 4827
- Pages
- 9
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- EUROPEAN RADIOLOGY
- Volume
- 27
- Number
- 11
- Start Page
- 4819
- End Page
- 4827
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/4500
- DOI
- 10.1007/s00330-017-4898-5
- ISSN
- 0938-7994
1432-1084
- Abstract
- 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 andDWI 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 x 10(-3) mm(2)/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 x 10(-3) mm(2)/ 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.
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- Appears in
Collections - 2. Clinical Science > Department of Anesthesiology and Pain Medicine > 1. Journal Articles
- 2. Clinical Science > Department of Radiology > 1. Journal Articles
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