The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve
| Autor: | Eda Yılmaz Akçay, Sehnaz Tezcan, Funda Ulu Ozturk, Nihal Uslu |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Washout curve Biopsy Contrast Media Breast Neoplasms Breast magnetic resonance imaging Diagnosis Differential Papilloma Intraductal Necrosis Young Adult Breast cancer Nuclear magnetic resonance medicine Humans Effective diffusion coefficient Radiology Nuclear Medicine and imaging Breast Diffusion (business) Fibrocystic Breast Disease Aged Retrospective Studies Aged 80 and over Observer Variation business.industry General Medicine Middle Aged medicine.disease Diffusion Magnetic Resonance Imaging Adipose Tissue ROC Curve Fibroadenoma Dynamic contrast-enhanced MRI Female business Diffusion MRI |
| Zdroj: | Canadian Association of Radiologists Journal. 72:460-469 |
| ISSN: | 1488-2361 0846-5371 |
| DOI: | 10.1177/0846537120907098 |
| Popis: | Purpose: The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI. Methods: The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated. Results: Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 × 10−3 mm2/s) was significantly lower than that of benign lesions (median ADC, 1.03 × 10−3 mm2/s; P < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 × 10−3 mm2/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 × 10−3 mm2/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies. Conclusion: Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve. |
| Databáze: | OpenAIRE |
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