Multiparametrische und molekulare Bildgebung von Brusttumoren mit MRT und PET‑MRT

Pinker, Katja; Marino, Maria Adele; Meyer‐Baese, Anke; Helbich, Thomas H.

doi:10.1007/s00117-016-0129-3

Cited by 8 publications

(4 citation statements)

References 60 publications

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“…A threshold of 1.3 × 10 −3 mm 2 /s for the ADC value was used as the cutoff for the differentiation between benign (> 1.3 × 10 −3 mm 2 /s) and malignant (≤ 1.3 × 10 −3 mm 2 /s) lesions [11, 25, 26].…”

Section: Methodsmentioning

confidence: 99%

Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

et al. 2019

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BackgroundAvailable data proving the value of DWI for breast cancer diagnosis is mainly for enhancing masses; DWI may be less sensitive and specific in non-mass enhancement (NME) lesions. The objective of this study was to assess the diagnostic accuracy of DWI using different ROI measurement approaches and ADC metrics in breast lesions presenting as NME lesions on dynamic contrast-enhanced (DCE) MRI.MethodsIn this retrospective study, 95 patients who underwent multiparametric MRI with DCE and DWI from September 2007 to July 2013 and who were diagnosed with a suspicious NME (BI-RADS 4/5) were included. Twenty-nine patients were excluded for lesion non-visibility on DWI (n = 24: 12 benign and 12 malignant) and poor DWI quality (n = 5: 1 benign and 4 malignant). Two readers independently assessed DWI and DCE-MRI findings in two separate randomized readings using different ADC metrics and ROI approaches. NME lesions were classified as either benign (> 1.3 × 10−3 mm2/s) or malignant (≤ 1.3 × 10−3 mm2/s). Histopathology was the standard of reference. ROC curves were plotted, and AUCs were determined. Concordance correlation coefficient (CCC) was measured.ResultsThere were 39 malignant (59%) and 27 benign (41%) lesions in 66 (65 women, 1 man) patients (mean age, 51.8 years). The mean ADC value of the darkest part of the tumor (Dptu) achieved the highest diagnostic accuracy, with AUCs of up to 0.71. Inter-reader agreement was highest with Dptu ADC max (CCC 0.42) and lowest with the point tumor (Ptu) ADC min (CCC = − 0.01). Intra-reader agreement was highest with Wtu ADC mean (CCC = 0.44 for reader 1, 0.41 for reader 2), but this was not associated with the highest diagnostic accuracy.ConclusionsDiagnostic accuracy of DWI with ADC mapping is limited in NME lesions. Thirty-one percent of lesions presenting as NME on DCE-MRI could not be evaluated with DWI, and therefore, DCE-MRI remains indispensable. Best results were achieved using Dptu 2D ROI measurement and ADC mean.

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Section: Methodsmentioning

confidence: 99%

Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

et al. 2019

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“…Dynamic curve modes were divided into three categories: the persistent pattern (type I), in which signal intensity increased continuously over time; the plateau pattern (type II), in which signal intensity did not vary with time after an initial increase in the delay phase; and the wash-out pattern (type III), in which signal intensity decreased after reaching its initial increase peak in the delay phase. The ADC threshold was 1.3×10 −3 mm 2 /s used as the cutoff between benign (>1.3×10 −3 mm 2 /s) and malignant (≤1.3×10 −3 mm 2 /s) lesions (6).…”

Section: Mr Imaging Evaluationmentioning

confidence: 99%

Non-mass enhancement breast lesions: MRI findings and associations with malignancy

Liu¹,

Liu²,

Chen³

et al. 2022

Ann Transl Med

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Background: Magnetic resonance imaging (MRI) is a multi-sequence imaging technique. Although MRI is the most sensitive method for detecting breast cancer, it is limited in evaluating the malignant possibility of non-mass enhanced (NME) breast lesions. It is also rarely reported whether MRI can further indicate the invasion of the lesions. In this article, we explore the differentiation of MRI characteristics between benign and malignant NME lesions and determine which features are associated with invasion. Methods:The MRI findings of 118 NME lesions were evaluated retrospectively to explore the characteristics of the benign and malignant NME lesions in different MRI sequences including dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI). The difference of MRI findings between benign and malignant NME lesions were determined by Pearson χ 2 test or Fisher's exact test, and the diagnostic value of features for malignancy was evaluated by receiver operating characteristic (ROC) curve.Results: This study included 118 NME lesions (62 benign and 56 malignant) in 118 patients. We found a segmental distribution, clustered-ring enhancement, wash-out dynamic curve, and lower apparent diffusion coefficient (ADC) value (P=0.01, <0.001, 0.02, 0.001) were associated with malignancy. Wash-out dynamic curves, diffusion restriction on DWI, lower ADC values were more advantageous in distinguishing invasive NME cancer from benign lesions than ductal carcinoma in situ (DCIS) (P<0.001, <0.001, 0.027). Further analysis showed that there were statistical differences between invasive carcinoma and carcinoma in situ in terms of wash-out dynamic curves, diffusion restriction on DWI and lower ADC values (P=0.001, 0.014, 0.024).Conclusions: MRI is a valuable way to identify malignant NME lesions and could predict the invasion of the lesions. Compared with carcinoma in situ, some sequences have more advantages in distinguishing invasive carcinoma from benign lesions.

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“…In our experience, during preoperative breast MRI, adding a turbo‐spin echo T2‐weighted sequence in coronal view to the classic protocol aids in assessment of the axilla.…”

Section: Axillary Lymph Node Assessmentmentioning

confidence: 99%

Lymph Node Imaging in Patients with Primary Breast Cancer: Concurrent Diagnostic Tools

Marino

Avendaño

Zapata³

et al. 2019

The Oncologist

128

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The detection of lymph node metastasis affects the management of patients with primary breast cancer significantly in terms of staging, treatment, and prognosis. The main goal for the radiologist is to determine and detect the presence of metastatic disease in nonpalpable axillary lymph nodes with a positive predictive value that is high enough to initially select patients for upfront axillary lymph node dissection. Features that are suggestive of axillary adenopathy may be seen with different imaging modalities, but ultrasound is the method of choice for evaluating axillary lymph nodes and for performing image-guided lymph node interventions. This review aims to provide a comprehensive overview of the available imaging modalities for lymph node assessment in patients diagnosed with primary breast cancer. The Oncologist 2020;25:e231-e242Implications for Practice: The detection of lymph node metastasis affects the management of patients with primary breast cancer. The main goal for the radiologist is to detect lymph node metastasis in patients to allow for the selection of patients who should undergo upfront axillary lymph node dissection. Features that are suggestive of axillary adenopathy may be seen with mammography, computed tomography, and magnetic resonance imaging, but ultrasonography is the imaging modality of choice for evaluating axillary lymph nodes. A normal axillary lymph node is characterized by a reniform shape, a maximal cortical thickness of 3 mm without focal bulging, smooth margins, and, depending on size, a discernable central fatty hilum.The Oncologist 2020;25:e231-e242 www.TheOncologist.com Breast Cancer Figure 7. Radiomics workflow. Reprinted by permission from Springer Nature, from Han et al., Radiomic nomogram for prediction of axillary lymph node metastasis in breast cancer. European Radiology 2019;7:3820-3829 [76].

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Multiparametrische und molekulare Bildgebung von Brusttumoren mit MRT und PET‑MRT

Cited by 8 publications

References 60 publications

Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

Non-mass enhancement breast lesions: MRI findings and associations with malignancy

Lymph Node Imaging in Patients with Primary Breast Cancer: Concurrent Diagnostic Tools

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