Diffusion tensor imaging of breast lesions: evaluation of apparent diffusion coefficient and fractional anisotropy and tissue cellularity

Jiang, Ruisheng; Ma, Zhuo; Hua, Dong; Sun, Shihang; Zeng, Xiangmin; Li, Xiao

doi:10.1259/bjr.20160076

Cited by 41 publications

(45 citation statements)

References 26 publications

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“…In concurrence, our data revealed a significant correlation between DTI parameters and histologic grades of EMCs. Previous studies have also shown a correlation between DTI parameters and tumor histologic grades in cerebral gliomas, breast cancer, and renal cancer; specifically, FA values tended to be lower with greater grade of malignancy, and this tendency may be due to intratumoral heterogeneity and higher cellular density . Previous studies have shown that differentiating among histologic grades of EMCs based on conventional ADC values is often difficult because of the considerable overlap among these values .…”

Section: Discussionmentioning

confidence: 99%

Endometrial carcinoma: Evaluation using diffusion‐tensor imaging and its correlation with histopathologic findings

Yamada

Wakana

Kobayashi

et al. 2018

Magnetic Resonance Imaging

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Background Although the prognosis of endometrial carcinoma (EMC) patients strictly depends on tumor invasion depth and its histologic grade, accurate preoperative assessment of these prognostic factors is often difficult. Purpose To determine the usefulness of diffusion‐tensor imaging (DTI) as a noninvasive method for evaluating tumor invasion depth and its histologic grade in patients with EMC. Study Type Prospective. Population Twenty‐five consecutive patients with histologically confirmed EMC who were surgically treated at our institution. Field Strength/Sequence DTI was performed with a 1.5T MRI system using a single‐shot echo‐planar imaging sequence with b values of 0 and 1000 s/mm2 and motion‐probing gradients in nine noncollinear directions. Assessment Fractional anisotropy (FA), mean diffusivity (MD), and axial diffusivity (AD) maps were analyzed by three observers and compared with histopathologic findings. Statistical Tests Dunnett's test, Spearman's rank correlation coefficient, and receiver operating characteristic (ROC) curve analyses. Results FA maps from all patients distinctly identified the junctional zone as a high‐FA zone (0.864 ± 0.037) that was significantly different from the endometrium and outer myometrium (0.251 ± 0.030 and 0.471 ± 0.091, respectively; P < 0.001). All EMCs were clearly depicted as hypointense areas on all DTI maps. AD maps provided the best tumor‐to‐uterus contrast, and EMCs (0.977 ± 0.120 × 10−3 mm2/s) had significantly lower AD values than all other layers of the normal uterine wall (2.166 ± 0.408, 2.010 ± 0.289, and 2.655 ± 0.203 × 10−3 mm2/s, respectively; P < 0.001). EMCs were clearly demarcated from the normal uterine wall, and DTI maps and histopathologic data yielded identical findings regarding tumor invasion depth. FA values showed a significant inverse correlation (r = –0.818; P < 0.001) with histologic grades 1, 2, and 3 of endometrioid adenocarcinomas. Data Conclusion In patients with EMC, DTI may be useful for evaluating tumor invasion depth and its histologic grade. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:250–260.

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Section: Discussionmentioning

confidence: 99%

Endometrial carcinoma: Evaluation using diffusion‐tensor imaging and its correlation with histopathologic findings

Yamada

Wakana

Kobayashi

et al. 2018

Magnetic Resonance Imaging

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“…Indeed, a large study evaluating 290 invasive breast cancers by Choi et al found lower ADC to be significantly associated with higher proliferation (based on the Ki‐67 index), which has been reiterated in several subsequent studies . Jiang et al recently found strong negative correlation between cellularity and ADC values in a cohort of 29 benign and 59 malignant breast lesions . A negative association has also been demonstrated between ADC and tumor grade in a small subset of studies, although the majority of studies have not found this trend to be significant.…”

Section: Clinical Applicationsmentioning

confidence: 97%

“…In differentiating breast lesions, a general consensus exists across studies regarding significantly reduced diffusivity (ADC or MD) in malignant tumors versus benign lesions. However, there are conflicting results regarding the diagnostic utility of the anisotropy indices, with several studies reporting lower FA in benign lesions compared with malignant lesions and others finding no difference in FA, warranting further investigation. One study reported the eigenvalue difference (λ 1 ‐λ 3 ), another measure of anisotropy, to significantly discriminate malignancy.…”

Section: Emerging Techniquesmentioning

confidence: 99%

“…[24][25][26] Jiang et al recently found strong negative correlation between cellularity and ADC values in a cohort of 29 benign and 59 malignant breast lesions. 27 A negative association has also been demonstrated between ADC and tumor grade in a small subset of studies, [28][29][30] although the majority of studies have not found this trend to be significant. Of interest, although estrogen receptor (ER)-positive breast cancers are in general associated with a better prognosis than ER-negative cancers, several authors have found ER-positivity to be associated with lower ADC values.…”

Section: Journal Of Magnetic Resonance Imagingmentioning

confidence: 99%

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Diffusion-weighted breast MRI: Clinical applications and emerging techniques

Partridge

Nissan²,

Rahbar

et al. 2016

J. Magn. Reson. Imaging

267

258

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Diffusion weighted MRI (DWI) holds potential to improve the detection and biological characterization of breast cancer. DWI is increasingly being incorporated into breast MRI protocols to address some of the shortcomings of routine clinical breast MRI. Potential benefits include improved differentiation of benign and malignant breast lesions, assessment and prediction of therapeutic efficacy, and non-contrast detection of breast cancer. The breast presents a unique imaging environment with significant physiologic and inter-subject variations, as well as specific challenges to achieving reliable high quality diffusion weighted MR images. Technical innovations are helping to overcome many of the image quality issues that have limited widespread use of DWI for breast imaging. Advanced modeling approaches to further characterize tissue perfusion, complexity, and glandular organization may expand knowledge and yield improved diagnostic tools.

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“…MD is an estimate of the average anisotropy, whereas FA reflects the degree of anisotropy . Both parameters strongly correlate to tissue cellularity . Partridge et al compared DTI measures of anisotropy in breast tumors and in normal breast tissue to study the potential value of DTI for the differential diagnosis of breast lesions .…”

Section: Introductionmentioning

confidence: 99%