Diffusion-weighted imaging of breast lesions: Region-of-interest placement and different ADC parameters influence apparent diffusion coefficient values

Bickel, Hubert; Pinker, Katja; Polanec, Stephan H.; Magometschnigg, Heinrich; Wengert, Georg; Spick, Claudio; Bogner, Wolfgang; Bagó-Horváth, Zsuzsanna; Helbich, Thomas H.; Baltzer, Pascal

doi:10.1007/s00330-016-4564-3

Cited by 85 publications

(76 citation statements)

References 41 publications

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“…Lesion ADC measurements differ significantly depending on the ROI selection approach, which can range from sampling a small subregion to whole tumor 3D ROI methods, Figure 5. Differences in ADC are most dramatic in large, heterogeneous, and non mass lesions [37, 52, 53]. Some studies have reported that a smaller ROI placed over the most hypointense ADC area may provide better discriminating performance by reflecting the worst pathology within a heterogeneous lesion [37, 53].…”

Section: Considerations For Clinical Implementationmentioning

confidence: 99%

“…Differences in ADC are most dramatic in large, heterogeneous, and non mass lesions [37, 52, 53]. Some studies have reported that a smaller ROI placed over the most hypointense ADC area may provide better discriminating performance by reflecting the worst pathology within a heterogeneous lesion [37, 53]. On the other hand, whole tumor measurement may allow better reproducibility [52].…”

Section: Considerations For Clinical Implementationmentioning

confidence: 99%

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DWI in the Assessment of Breast Lesions

Partridge

Amornsiripanitch

2017

Topics in Magnetic Resonance Imaging

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Diffusion-weighted MRI (DWI) holds promise to address some of the shortcomings of routine clinical breast MRI and to expand the capabilities of imaging in breast cancer management. DWI reflects tissue microstructure, and provides unique information to aid in characterization of breast lesions. Potential benefits under investigation include improving diagnostic accuracy and guiding treatment decisions. As a result, DWI is increasingly being incorporated into breast MRI protocols and multicenter trials are underway to validate single institution findings and to establish clinical guidelines. Advancements in DWI acquisition and modeling approaches are helping to improve image quality and extract additional biologic information from breast DWI scans, which may extend diagnostic and prognostic value.

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Section: Considerations For Clinical Implementationmentioning

confidence: 99%

Section: Considerations For Clinical Implementationmentioning

confidence: 99%

DWI in the Assessment of Breast Lesions

Partridge

Amornsiripanitch

2017

Topics in Magnetic Resonance Imaging

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“…A major strength of DWI is that ADC is a quantitative parameter, which measurement can be used in clinical practice as a quantitative imaging biomarker (QIB) . DWI with ADC mapping has been proposed as a QIB for determination of tumor prognostic and predictive factors .…”

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confidence: 99%

“…However, to date results on ADC as a QIB to predict receptor status are divergent. We believe that this might be due to different measurement approaches, ie, measurements of the entire tumor vs. subjectively chosen areas, which have been utilized across studies . We hypothesized that ADC as a QIB can predict IHC receptor status, proliferation rate, and molecular tumor subtypes of breast cancer.…”

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confidence: 99%

Diffusion‐weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping as a quantitative imaging biomarker for prediction of immunohistochemical receptor status, proliferation rate, and molecular subtypes of breast cancer

Horvat

Bernard‐Davila

Helbich

et al. 2019

Magnetic Resonance Imaging

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Background Diffusion‐weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping is one of the most useful additional MRI parameters to improve diagnostic accuracy and is now often used in a multiparameric imaging setting for breast tumor detection and characterization. Purpose To evaluate whether different ADC metrics can also be used for prediction of receptor status, proliferation rate, and molecular subtype in invasive breast cancer. Study Type Retrospective. Subjects In all, 107 patients with invasive breast cancer met the inclusion criteria (mean age 57 years, range 32–87) and underwent multiparametric breast MRI. Field Strength/Sequence 3 T, readout‐segmented echo planar imaging (rsEPI) with IR fat suppression, dynamic contrast‐enhanced (DCE) T1‐weighted imaging, T2‐weighted turbo‐spin echo (TSE) with fatsat. Assessment Two readers independently drew a region of interest on ADC maps on the whole tumor (WTu), and on its darkest part (DpTu). Minimum, mean, and maximum ADC values of both WTu and DpTu were compared for receptor status, proliferation rate, and molecular subtypes. Statistical Tests Wilcoxon rank sum, Mann–Whitney U‐tests for associations between radiologic features and histopathology; histogram and q‐q plots, Shapiro–Wilk's test to assess normality, concordance correlation coefficient for precision and accuracy; receiver operating characteristics curve analysis. Results Estrogen receptor (ER) and progesterone receptor (PR) status had significantly different ADC values for both readers. Maximum WTu (P = 0.0004 and 0.0005) and mean WTu (P = 0.0101 and 0.0136) were significantly lower for ER‐positive tumors, while PR‐positive tumors had significantly lower maximum WTu values (P = 0.0089 and 0.0047). Maximum WTu ADC was the only metric that was significantly different for molecular subtypes for both readers (P = 0.0100 and 0.0132) and enabled differentiation of luminal tumors from nonluminal (P = 0.0068 and 0.0069) with an area under the curve of 0.685 for both readers. Data Conclusion Maximum WTu ADC values may be used to differentiate luminal from other molecular subtypes of breast cancer. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:836–846.

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“…ROI WT can overcome this problem; however, a long postprocessing time limits its wide application . The influence of ROI selection methods on the measurement of the apparent diffusion coefficient value has been widely studied, and its influence on DCE‐MRI‐derived parameters has been only studied in patients with renal cell carcinoma and head and neck cancer …”

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confidence: 99%

Dynamic contrast‐enhanced MRI in orbital lymphoproliferative disorders: Effects of region of interest selection methods on time efficiency, measurement reproducibility, and diagnostic ability

Qian

et al. 2017

Magnetic Resonance Imaging

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Diffusion-weighted imaging of breast lesions: Region-of-interest placement and different ADC parameters influence apparent diffusion coefficient values

Abstract: • Region of interest placement significantly influences apparent diffusion coefficient of breast tumours. • Minimum and mean apparent diffusion coefficient perform best and are reproducible. • 2D regions of interest perform best and provide rapid measurement times.

Cited by 85 publications

References 41 publications

DWI in the Assessment of Breast Lesions

DWI in the Assessment of Breast Lesions

Diffusion‐weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping as a quantitative imaging biomarker for prediction of immunohistochemical receptor status, proliferation rate, and molecular subtypes of breast cancer

Dynamic contrast‐enhanced MRI in orbital lymphoproliferative disorders: Effects of region of interest selection methods on time efficiency, measurement reproducibility, and diagnostic ability

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