Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma

Abstract

Purpose: To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC mean , ADC minimal ) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma. Materials and Methods:A total of 107 women with invasive ductal cancer underwent breast MRI. The ADC mean and ADC minimal of the cancers were computed. MRI findings were retrospectively evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or nonmass type, mass shape, mass margin, nonmass distribution, and enhancement pattern. Histological records were reviewed for tumor size, lymph node metastasis, histologic grade, and expression of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2(HER2), Ki-67, and epidermal growth factor receptors (EGFR). Correlations of ADC values and MR findings with prognostic factors were determined using the Mann-Whitney U-test and the Kruskal-Wallis test.Results: The mean ADC minimal was 0.78 6 0.24 (Â10 À3 mm 2 /s), and the mean ADC mean was 1.01 6 0.23 (Â10 À3 mm 2 /s). There was a significant correlation of the ADCmean value with ER expression (P ¼ 0.027) and HER2 expression (P ¼ 0.018). There was no significant relationship between ADC minimal and prognostic factors or between ADC mean and traditional prognostic factors, PR, Ki-67 and EGFR. The majority of the mass type lesions were less than 5 cm in size and the majority of nonmass type lesions were more than 2 cm in size (P ¼ 0.022). The margin of mass was significantly associated with lymph node metastasis (P ¼ 0.031), ER expression (P ¼ 0.013), PR expression (P ¼ 0.036), HER2 expression (P ¼ 0.019), and EGRF expression (P ¼ 0.041). The rim internal enhancement was significantly correlated with Ki-67 expression (P ¼ 0.008). Conclusion:The low ADC mean value was related to positive expression of ER and negative expression of HER2. A spiculated margin was related to a good prognosis, but rim enhancement was associated with a poor prognosis.

Correlation of the apparent diffusion coefficiency values on diffusion-weighted imaging with prognostic factors for breast cancer

“…Breast MRI is an established supplemental technique to mammography and ultrasonography for evaluation of suspicious breast lesions. Diffusion-weighted MRI (DWI) has recently been integrated into the standard breast MRI for discrimination of benign and malignant breast lesions obtained with dynamic contrast-enhanced MRI [1][2][3][4][5][6][7][8][9][10][11][12][13]. DWI is a non-invasive technique that represents the biological character of the mainly Brownian movement of protons in bulk water molecules in vivo.…”

Diagnostic Significance of Apparent Diffusion Coefficient Values with Diffusion Weighted MRI in Breast Cancer: a Meta-Analysis

“…In this regard, we postulated that DWI may be valuable in the detection of LNM since it exhibits reduced ADC values in malignant BC. Several studies have illustrated that LNM in BC may be evaluated via the ADC quantified by DWI (Fornasa et al, 2012;Luo et al, 2012), while other documents also reported contradictory findings (Jeh et al, 2011;Choi et al, 2012). Therefore, the present meta-analysis was performed to assess the feasibility of DWI in the diagnosis of LNM in BC.…”

“…Additionally, as for the step of screening, a flow chart of the study selection process was displayed in Figure 1. Initially, a total of 603 papers were selected from the 9 databases through screening the title and key words (Nakajo et al, 2010;Razek et al, 2010;Jeh et al, 2011;Nakai et al, 2011;Choi et al, 2012;Fornasa et al, 2012;Luo et al, 2012;Kamitani et al, 2013;Luo et al, 2013). Followed by excluding the duplicates (n=2), letters, reviews or meta-analysis (n=128), non-human studies (n=137), and the studies not related to research topics (n=145), the left studies (n=191) were reviewed and additional 179 studies were excluded in that they were not case-control or cohort study (n=48), not relevant to diffusion MRI (n=62), or not relevant to BC (n=69).…”

“…After tumor invasion, the normal structure of lymph nodes is destroyed, and the normal tissue is replaced by tumor lymphatic tissue, leading to enlarged tumor cell nuclei, increased nuclear/cytoplasmic ratio, and significant nuclear specificity (Parsian et al, 2012). As a result, tumor cells increased and arranged closely, resulting in reduced extracellular space, vascular disorders in the lymph nodes, increased water molecules and restricted diffusion, thereby reducing the ADC value (Jeh et al, 2011;Choi et al, 2012). In this regard, we postulated that DWI may be valuable in the detection of LNM since it exhibits reduced ADC values in malignant BC.…”

Diffusion weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging

“…Less aggressive tumors (Grade 1 and in situ lesions) displayed an average ADC value of 1.19×10 -3 mm 2 /s, whereas more aggressive tumors (Grades 2 and 3) had an average ADC value of 0.96×10 -3 mm 2 /s. Another study found a significant correlation between the average ADC value of invasive ductal carcinoma of the breast and estrogen receptor (ER) and HER2 expression (47).…”