Diffusion tensor imaging parameters in differentiation recurrent breast cancer from post-operative changes in patients with breast-conserving surgery

Razek, Ahmed Abdel Khalek Abdel; Zaky, Mona; Bayoumi, Dalia; Taman, Saher; Abdelwahab, Khaled; Alghandour, Reham

doi:10.1016/j.ejrad.2018.12.022

Cited by 30 publications

(7 citation statements)

References 38 publications

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“…Previous study demonstrated a positive correlation between FA and tumor cell density in glioblastomas (32). Besides, complicated and disordered structures with regional hemorrhage or liquefactive necrosis were more easily seen in cancerous tissues, which may enhance the diffusion of water molecules in certain directions while reduced in others in the more disordered microstructures of cancerous tissues (23). This partly explained the increase of anisotropy in breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Diffusion Tensor Imaging for Characterizing Breast Tumors: A Comprehensive Meta-Analysis

Wang

et al. 2019

Front. Oncol.

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Rationale and Objectives: Controversy still exists on the diagnosability of diffusion tensor imaging (DTI) for breast lesions characterization across published studies. The clinical guideline of DTI used in the breast has not been established. This meta-analysis aims to pool relevant evidences and evaluate the diagnostic performance of DTI in the differential diagnosis of malignant and benign breast lesions.Materials and Methods: The studies that assessed the diagnostic performance of DTI parameters in the breast were searched in Embase, PubMed, and Cochrane Library between January 2010 and September 2019. Standardized mean differences and 95% confidence intervals of fractional anisotropy (FA), mean diffusivity (MD), and three diffusion eigenvalues (λ1, λ2, and λ3) were calculated using Review Manager 5.2. The pooled sensitivity, specificity, and area under the curve (AUC) were calculated with a bivariate model. Publication bias and heterogeneity between studies were also assessed using Stata 12.0.Results: Sixteen eligible studies incorporating 1,636 patients were included. The standardized mean differences indicated that breast cancers had a significantly higher FA but lower MD, λ1, λ2, and λ3 than those of benign lesions (all P < 0.05). Subgroup analysis indicated that invasive breast carcinoma (IBC) had a significantly lower MD value than that of ductal carcinoma in situ (DCIS) (P = 0.02). λ1 showed the best diagnostic accuracy with pooled sensitivity, specificity, and AUC of 93%, 92%, and 0.97, followed by MD (AUC = 0.92, sensitivity = 87%, specificity = 83%) and FA (AUC = 0.76, sensitivity = 70%, specificity = 70%) in the differential diagnosis of breast lesions.Conclusion: DTI with multiple quantitative parameters was adequate to differentiate breast cancers from benign lesions based on their biological characteristics. MD can further distinguish IBC from DCIS. The parameters, especially λ1 and MD, should attract our attention in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Diffusion Tensor Imaging for Characterizing Breast Tumors: A Comprehensive Meta-Analysis

Wang

et al. 2019

Front. Oncol.

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“…Magnetic resonance (MR) imaging has proven useful in the pretreatment survey of uterine malignancies [9]. With the routine and emerging advanced imaging sequences such as diffusion-weighted (DW), whose measurement were reflected by the biophysical characteristics of the tissue, rendered the discrimination of malignant from benign [10, 11]. More than 60% of benign leiomyomas demonstrate T2 hypointensity as compared with the myometrium [12].…”

Section: Introductionmentioning

confidence: 99%

Utility of diffusion-weighted and contrast-enhanced magnetic resonance imaging in diagnosing and differentiating between high- and low-grade uterine endometrial stromal sarcoma

et al. 2019

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Background Endometrial stromal sarcoma (ESS) is a rare uterine malignancy that features different prognoses for its high- and low-grade subtypes. We investigated the diagnostic accuracy of magnetic resonance (MR) imaging in diagnosing and differentiating between high- and low-grade ESS. Methods We retrospectively reviewed the preoperative pelvic MR images of consecutive patients who received histologically confirmed diagnoses of high-grade ESS (n = 11) and low-grade ESS (n = 9) and T2-hyperintense leiomyoma (n = 16). Two radiologists independently evaluated imaging features in T1-, T2-, and diffusion-weighted and contrast-enhanced MR images. Statistical analysis included Mann-Whitney tests and Fisher’s exact test, with sensitivity, specificity and diagnostic accuracy of imaging features. Results High-grade ESS was associated with significantly more extensive necrosis and hemorrhage and distinct feather-like enhancement compared with low-grade ESS (P < .05 for all). The feather-like enhancement pattern yielded a diagnostic accuracy of 95%, sensitivity of 91%, and specificity of 100% in differentiating high-grade from low-grade ESS. This imaging characteristic was significantly superior to the necrosis (80%, P = .033) or hemorrhage (75%, P = .007). Both high- and low-grade ESS demonstrated T2 hypointense bands, marginal nodules, intratumoral nodules, and worm-like intra-myometrial nodules, and their tumor apparent diffusion coefficient (ADC) values were significantly lower than those of T2-hyperintense leiomyomas (P < .001). Conclusions Diffusion-weighted MR imaging is useful in diagnosing ESS against T2-hyperintense leiomyomas, and contrast enhancement aids in further differentiating between high- and low-grade ESS.

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“…The possible reason for that the chances of a malignant tumor are less than the benign tumor in the breast cancer screening. [24] Ultrasound elastography has the limitation of detection of DCIS, [17,25] for example, the ratio of an elasticity imaging to B-mode was found 1 or less in case of DCIS. Also, ultrasound is not completely reliable and controversial for the detection of nodal metastases of breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Contrast ultrasound versus ultrasound elastography for diagnosis of breast lumps

Zhao

Yan²,

Liu³

et al. 2019

Medicine

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Chinese women have dense and small breasts. Therefore, in China, contrast ultrasound and ultrasound elastography are commonly used for detection of the breast lumps. Purpose of the study was to compare the sensitivity and accuracy of ultrasound elastography with contrast ultrasound for the diagnosis of the breast lumps. A total of 1000 women with a damp in breast mass, breast pain, nipple discharge, and/or breast skin discharge were subjected to contrast ultrasound and ultrasound elastography. Women were subjected to stereotactic vacuum-assisted biopsy under B-mode ultrasonography (n = 750). The ultrasound examinations were graded on a 5-points scale method. Data were subjected to the Chi-square Independence test at 99% of confidence level. Ultrasound elastography was detected the same numbers of benign lesions (648 vs 651, P = .88), malignant lesions (90 vs 99, P = .53), and false positive lesions (5 vs 0, P = .07) as those detected by biopsies. However, diagnostic parameters for contrast ultrasound had a significant difference with those detected by biopsies ( P < .0001 for all). For contrast ultrasound and ultrasound elastography, the working area to detect deformation in the image of the breast lesions at least 1 time were 0% to 45% and 5% to 100%. Ultrasound elastography is the most reliable diagnostic method for detection of the breast lumps.

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Diffusion tensor imaging parameters in differentiation recurrent breast cancer from post-operative changes in patients with breast-conserving surgery

Cited by 30 publications

References 38 publications

Diagnostic Performance of Diffusion Tensor Imaging for Characterizing Breast Tumors: A Comprehensive Meta-Analysis

Diagnostic Performance of Diffusion Tensor Imaging for Characterizing Breast Tumors: A Comprehensive Meta-Analysis

Utility of diffusion-weighted and contrast-enhanced magnetic resonance imaging in diagnosing and differentiating between high- and low-grade uterine endometrial stromal sarcoma

Contrast ultrasound versus ultrasound elastography for diagnosis of breast lumps

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