Role of quantitative diffusion weighted imaging in characterization of breast masses

Ibrahim, Yosra Abdelzaher; Habib, Lobna Abdelmonem; Deif, Ahmed

doi:10.1016/j.ejrnm.2015.05.006

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…In this study the breast lesions differentiated with high sensitivity (100%) and high specificity (82.8%) as benign or malignant with the aid of ADC readings and a cutoff value of (1.31x10 -3 mm 2 /sec). Our result were relatively in agreement with Ibrahim et al [21] who found that the median value of ADC for malignant lesions was 0.93 × 10 −3 mm 2 /s and the median value of ADC for benign lesions was 1.51 × 10 −3 mm 2 /s. In this study there were 3 abscess lesions, two of them displayed restricted diffusion, the mean of ADC value was 0.85× 10 -3 mm 2 /s & one case of intraductal papilloma with low ADC value, benign papillary lesions frequently showed restriction at diffusion images which may confuse in the diagnosis of the papillary lesions both at DCE-MRI and DWI, also we note there is some lesion with partial restriction such as fat necrosis which also showed low ADC value (due to high viscosity), lead to false-positive DWI results.…”

Section: Discussionsupporting

confidence: 93%

“…When measuring the ADC number, the suspected lesion should be shown on the ADC map and diffusion-weighted images and the region of interest must be placed carefully over the solid part of the tumor and to assure the cystic or necrotic parts as well as the normal breast parenchyma are not included in this region [6] Abscess and Hemorrhage may demonstrate low value of ADC, comparable to malignant diseases. So it should be conducted with other MRI sequences such as T2 and T1 weighted image to avoid misdiagnosis [21] . Nonmass lesions such as DCIS and fibrocystic changes can show in between normal fibro-glandular tissue or fatty tissue, which might impact the measurement of ADC.…”

Section: Dwi In Breastmentioning

confidence: 99%

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The cut-off value of ADC to differentiate benign from malignant breast lesions

Fareed¹,

Mahmmud²,

Abdulhakeem³

2021

Int. J. Radiol. Diagn. Imaging

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Background: Diffusion-weighted MRI is a fast, unenhanced modality that shows promise in identifying mammographically occult malignancy and warrants further investigation as an alternative supplemental breast cancer screening tool. Aim of study: To estimate the diagnostic accuracy of diffusion wighted imaging and apparent diffusion coeffient (ADC) value in the differentiation between benign and malignant breast lesions, and to obtain a cutoff ADC value between benign and malignant breast lesions along with histopathological correlation. Materials and Methods: A prospective study of 56 patients with present with breast mass who examined at 1.5 tesla MRI & proved by histopathology. ADC value were a quired at b values of 0, 600, 850 s/mm² after identification of ROI (Region of interest) placement. ADC value with histopathology correlation was analyzed. Results: From total 56 lesions, 24 lesions were histologically malignant and 32 were histologically benign. With an ADC cut-off value of 1.31 × 10−3 mm2/s for malignant lesions, a sensitivity of 100% and specificity of 72.1% was obtained. The false-postive lesions were one intraductal papilloma & 3 abcesses in which a low ADC value was obtained. Purely DCIS (Ductal carcinoma in situ) lesions presenting as non-mass-like enhancement had a high ADC value of 1.2-1.3 × 10−3 mm2/s, thereby decreasing specificity. Conclusion: Diffusion-weighted Imaging is a functionl quantitative assessment by ADC value, may act as an efficient tool in increasing the diagnostic accuracy and specificity of breast MRI in the characterization of different breast lesions.

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Section: Discussionsupporting

confidence: 93%

Section: Dwi In Breastmentioning

confidence: 99%

The cut-off value of ADC to differentiate benign from malignant breast lesions

Fareed¹,

Mahmmud²,

Abdulhakeem³

2021

Int. J. Radiol. Diagn. Imaging

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“…This indicated that DWI has a high specificity in the diagnosis of malignant lesions. Some authors also demonstrated that the ADC can be used to differentiate malignant breast lesions from benign lesions (20–24). Meanwhile, the value of ADC could be used as an imaging biomarker for the diagnosis of breast cancer (25–28).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of multiparametric MRI in distinguishing the breast malignant lesions from benign lesions: a meta-analysis

et al. 2020

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Background The sensitivity of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for detecting breast cancer was high and the specificity was relatively low. However, diffusion-weighted imaging (DWI) has a high specificity in the diagnosis of malignant lesions. Purpose To evaluate the accuracy of the multiparametric MRI (mp-MRI) in distinguishing the breast malignant lesions from the benign lesions. Material and Methods A comprehensive search of the PubMed, Embase, and Cochrane Library electronic databases was conducted up to March 2020. Data were analyzed for the following indexes: pooled sensitivity and specificity; positive likelihood ratio; negative likelihood ratio; diagnostic odds ratio; and the area under the curve. Results A total of 2356 patients with 1604 malignant and 967 benign breast lesions were included from 22 studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve for mp-MRI were 0.93, 0.85, 6.3, 0.08, 81, and 0.96, respectively. The pooled sensitivity, specificity, and area under the curve for DCE-MRI alone were 0.95, 0.71, and 0.92, respectively. The pooled sensitivity, specificity, and area under the curve for DWI alone were 0.88, 0.84, and 0.93, respectively. Conclusion The mp-MRI did not improve the sensitivity but increased the specificity for the diagnosis of breast malignant lesions.

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“…The number of malignant and benign lesions ranged from 14-259 and 8-161, respectively, with a mean of 61 malignant and 36 benign lesions per study subset. Seven study subsets were categorized as BTTS1: whole breast tumor tissue selection [35,[38][39][40][41][42][43], 22 as BTTS2: subtracted whole breast tumor tissue selection [15][16][17]20,23,36,37,[44][45][46][47][48][49][50][51][52][53][54][55][56][57][58], 19 as BTTS3: circular breast tumor tissue selection [18,19,21,24,25,36,[59][60][61][62][63][64][65][66][67][68][69][70][71] and 17 as BTTS4: lowest diffusion breast tumor tissue selection…”

Section: Characteristics Of the Studies Includedmentioning

confidence: 99%

Diagnostic performance of breast tumor tissue selection in diffusion weighted imaging: A systematic review and meta-analysis

et al. 2020

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Background Several methods for tumor delineation are used in literature on breast diffusion weighted imaging (DWI) to measure the apparent diffusion coefficient (ADC). However, in the process of reaching consensus on breast DWI scanning protocol, image analysis and interpretation, still no standardized optimal breast tumor tissue selection (BTTS) method exists. Therefore, the purpose of this study is to assess the impact of BTTS methods on ADC in the discrimination of benign from malignant breast lesions in DWI in terms of sensitivity, specificity and area under the curve (AUC). Methods and findings In this systematic review and meta-analysis, adhering to the PRISMA statement, 61 studies, with 65 study subsets, in females with benign or malignant primary breast lesions (6291 lesions) were assessed. Studies on DWI, quantified by ADC, scanned on 1.5 and 3.0 Tesla and using b-values 0/50 and � 800 s/mm 2 were included. PubMed and EMBASE were searched for studies up to 23-10-2019 (n = 2897). Data were pooled based on four BTTS methods (by definition of measured region of interest, ROI): BTTS1: whole breast tumor tissue selection, BTTS2: subtracted whole breast tumor tissue selection, BTTS3: circular breast tumor tissue selection and BTTS4: lowest diffusion breast tumor tissue selection. BTTS methods 2 and 3 excluded necrotic, cystic and hemorrhagic areas. Pooled sensitivity, specificity and AUC of the BTTS methods were calculated. Heterogeneity was explored using the inconsistency index (I 2) and considering covariables: field strength, lowest bvalue, image of BTTS selection, pre-or post-contrast DWI, slice thickness and ADC threshold. Pooled sensitivity, specificity and AUC were

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Role of quantitative diffusion weighted imaging in characterization of breast masses

Cited by 7 publications

References 19 publications

The cut-off value of ADC to differentiate benign from malignant breast lesions

The cut-off value of ADC to differentiate benign from malignant breast lesions

Accuracy of multiparametric MRI in distinguishing the breast malignant lesions from benign lesions: a meta-analysis

Diagnostic performance of breast tumor tissue selection in diffusion weighted imaging: A systematic review and meta-analysis

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