Improving malignancy prediction in breast lesions with the combination of apparent diffusion coefficient and dynamic contrast-enhanced kinetic descriptors

Nogueira, Luísa; Brandão, Sofia; Matos, Eduarda; Nunes, Rita G.; Ferreira, Hugo Alexandre; Loureiro, Joana; Ramos, Isabel

doi:10.1016/j.crad.2015.05.009

Cited by 9 publications

(28 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Breast cancer is a heterogeneous tumor with different molecular patterns and remains the second leading cause of cancerrelated death after lung cancer. [1][2][3] In recent years, besides the ultrasound and mammography, breast MRI has become a widespread modality in the diagnosis of breast cancer. Dynamic contrast-enhanced MRI yields information about enhancement of the lesion by using kinetic curves to differentiate benign lesions from malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Diffusion-weighted imaging is sensitive to biophysical characteristics of tissues and affected by tissue cellularity, edema, and necrosis. 2,3,[18][19][20] The majority of the studies performed up to the present indicated that lower ADC values with the variable ADC cutoff values were significantly associated with malignancy. 2,3,10,14,[18][19][20] And also some previous studies revealed that combined analysis of DCE-MRI and DWI had a potential role in the detection of malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…1 Breast malignancies have variable vascularization patterns, which help radiologist to differentiate malignity from benign lesions. [1][2][3][4] These patterns are classified due to the internal enhancement pattern, distribution of the enhancement, and kinetic studies on DCE-MRI. 5 According to the Breast Imaging Reporting and Data System (BI-RADS) lexicon, kinetic curves are classified as exhibiting a ''washout,'' ''plateau,'' or ''persistent'' shape.…”

Section: Introductionmentioning

confidence: 99%

“…The diffusion-weighted image provides quantitative information of water diffusion in the lesions using apparent diffusion coefficient (ADC) maps, which represents the tumor cellularity and cell membrane integrity. 2,3,10 When tissue cellularity increases, the extracellular volume reduces, and this result in reduction in diffusion of extracellular water molecules. 14 The infiltration of malignant tumor cells leads to diffusion restriction on DWI.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have recently shown an inverse correlation between cellular density and ADC values, with malignancies having higher cellularity and lower ADC values when compared with benign lesions. [2][3][4]10,14,15 The diffusion-weighted image has also a potential role in the determination of aggressiveness of a tumor and the evaluation of response to therapy. 14,15 The combination of DCE-MRI and DWI may increase the diagnostic value of breast MRI in lesions presenting type 3 kinetic curves.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve

Tezcan¹,

Ozturk

Uslu

et al. 2020

Can Assoc Radiol J

View full text Add to dashboard Cite

Purpose: The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI. Methods: The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated. Results: Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 × 10−3 mm2/s) was significantly lower than that of benign lesions (median ADC, 1.03 × 10−3 mm2/s; P < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 × 10−3 mm2/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 × 10−3 mm2/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies. Conclusion: Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve.

show abstract

Section: Discussionmentioning

confidence: 99%