Detection of invasive components in cases of breast ductal carcinoma in situ on biopsy by using apparent diffusion coefficient MR parameters

Abstract

• Identification of invasive components in DCIS before treatment is clinically important. • Diffusion-weighted MR imaging can help lesion assessment in breast cancer. • The minimum ADC value may suggest the presence of an invasive component in DCIS. • The ADC difference value also suggests the presence of an invasive component in DCIS. • Preoperative evaluation of diffusion-weighted MR imaging may help surgical planning for DCIS.

Simple magnetic resonance imaging criteria can differentiate ductal carcinomas in situ from invasive carcinomas

“…They have studied a similar ADC threshold to ours (1.10x10 -3 mm 2 /s), but obtained greater accuracy (AUC=0.895), with sensitivity of 78.06% and specificity of 90.5%. Our results are more in keeping with those attained by Mori et al 14 , who investigated if DWI could be used to distinguish pure DCIS from DCIS with occult invasive component. Their diagnostic performance, as assessed by ROC curves, was exactly the same as ours (AUC=0.71) for the minimum ADC values.…”

“…There is evidence that these measurements are even correlated to biologic minutiae like the histologic grades of DCIS 13 . As a logical consequence, it could potentially discriminate pre-invasive from invasive carcinomas, leading to relevant therapeutic management implications 14 . In this study, we intend to investigate (a) if ADC measurements of DCIS are significantly different from those of invasive breast carcinomas, and (b) what would be the incremental gain of a predictive model that incorporates ADC values and simple DCE-MRI criteria.…”

Differences in morphological features and minimum apparent diffusion coefficient values among breast cancer subtypes using 3-tesla MRI

“…The ADC reflects the microenvironment of the tissue structures and is therefore related to the malignant features, such as cellularity, of the tumor. Most of the studies used mean ADC 6,9 ; however, the usefulness of minimum (min) ADC, which may reflect the most malignant portions of the tumor, in differentiating between malignant and benign breast masses and in detecting an invasive component in ductal carcinoma in situ has recently been reported 12,13 . Additionally, ADC might reflect other characteristics of tissue structures, such as the amount of fibrous stroma and the pg.…”

Correlation between minimum apparent diffusion coefficient values and the histological grade of breast invasive ductal carcinoma

“…The majority of these aforementioned studies have applied the multiple ROI method in breast MRI, and the ADC min value represented the lowest mean ADC value among multiple small ROIs within the lesion. However, this method is time-consuming, limiting its clinical application (21,25,27). In the present study, the single ROI was smaller in size when compared with the lesion size, and was placed in the solid part of the IDC, avoiding the necrotic and hemorrhagic regions.…”

“…There have been several studies investigating the application of the ADC min values in differentiating the benign and malignant breast masses (as well as in differentiating breast cancer subtypes), and in detecting the invasive component in ductal carcinoma in situ (21,25,26). Byun et al (27) have measured the mean ADC and the mean ADC min values in the regions with the highest fluorodeoxyglucose (FDG) uptake using sequential 18 F-FDG positron-emission tomography and MRI, and examined the correlation of the corresponding ADC values with the histological grade of IDC.…”