Diffusion Weighted Imaging of Different Breast Cancer Molecular Subtypes. A Systematic Review and Meta Analysis.

Abstract

Background: Magnetic resonance imaging can be used to diagnose breast cancer (BC)s. Diffusion weighted imaging and the apparent diffusion coefficient (ADC) can be used to reflect tumor microstructure. The present analysis sought to compare ADC values between molecular subtypes of BC based upon a large patient sample.Methods: MEDLINE library and SCOPUS databases were screened for the associations between ADC and molecular suptype of BC to April 2020. Primary endpoint of the systematic review was the ADC value in different BC. Overall, 28 studies were suitable for the analysis and included into the present study.Results: The included studies comprised a total of 2990 tumors. Luminal A type was diagnosed in 865 cases (28.9%), Luminal B in 899 cases (30.1%), Her-2 enriched in 597 cases (20.0%) and triple negative in 629 cases (21.0%). The mean ADC value of the Luminal A type was 0.99 × 10− 3 mm2/s [95% CI 0.94-1.04], of the Luminal B type was 0.99 × 10− 3 mm2/s [95% CI 0.89-1.05], of Her 2-enriched type was 1.02 × 10− 3 mm2/s [95% CI 0.95-1.08] and of the triple negative type was 0.99 × 10− 3 mm2/s [95% CI 0.91-1.07].Conclusions: ADC values cannot be used to discriminate between molecular subtypes of BC.

DWI of the Breast – Possibilities and Limitations

“…A meta-analysis based on 28 studies including 2990 tumors examined this data and did not show any significant differences in ADC value between the different immunohistochemical subtypes 34 .…”

“…Eine erste Meta-Analyse basierend auf 28 Studien mit 2990 Karzinomen konnte diese Daten vereinheitlichen und zeigte ebenfalls keine signifikanten Unterschiede der ADC-Werte zwischen den verschiedenen immunhistochemischen Subtypen 34 .…”

The Role of Breast Imaging in Pre- and Post-Definitive Treatment of Breast Cancer

“…Apparent diffusion coefficient (ADC) is the main limitation of DWI in clinical practice due to its heterogeneity, which is basically defined as diffusion rates, or water-occupied area per unit time. A meta-analysis by Jonas-Meyer mentioned that the variability of ADC among breast cancer subtypes is insignificant (48,49). Magnetic resonance elastography (MRE) is aimed at determining the differences in biomechanical properties (stiffness, or elasticity) between normal and malignant breast tissues.…”