The role of diffusion weighted imaging as supplement to dynamic contrast enhanced breast MRI: Can it help predict malignancy, histologic grade and recurrence?

Roknsharifi, Shima; Fishman, Michael; Agarwal, Monica D.; Brook, Alexander; Kharbanda, Vritti; Dialani, Vandana

doi:10.1016/j.acra.2018.09.003

Cited by 24 publications

(23 citation statements)

References 32 publications

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“…Fifteen cases (30%) showed restricted diffusion with ADC values in the range of 0.72±1.09(×10 −3 mm 2 /s), with a mean of 0.88±0.13.No diffusion restriction was reported in 35 cases (30%) with ADC ranging from 1.22−1.81(×10 −3 mm 2 /s), with a mean of 1.38±0.18(×10 −3 mm 2 /s). These outcomes were consistent with the previously reported results [48,49].…”

Section: Discussionsupporting

confidence: 94%

WITHDRAWN: Assessment of Suspected Breast Lesions in Early Stage Triple Negative Breast Cancer During Follow-up After Breast Conserving Surgery Using Multiparmetric MRI

Sad¹,

Dabees²,

Mohamed³

et al. 2020

Preprint

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Background: The local recurrence rate in triple negative breast cancer (TNBC) can be as high as 12%.The standard treatment for early-stage TNBC is breast conserving surgery (BCS), followed by postoperative radiotherapy with or without chemotherapy. However, detection of the local recurrence of the disease after radiotherapy is a major issue.Objective: The aim of this study was to investigate the role of dynamic and functional magnetic resonance imaging (MRI) during follow-up after BCS and radiotherapy with/without chemotherapy to differentiate between loco regional recurrence and postoperative fibrosis.Patients and methods: This prospective study was conducted at Oncology, Radiology, and Pathology Departments, Tanta University. It involved 50 patients with early-stage TNBC who were treated with BCS, followed by radiotherapy with/without chemotherapy. The suspected lesions were evaluated during the follow-up period by sonomammography. All patients were subjected to MRI, including conventional sequences, diffusion-weighted imaging (DWI), and dynamic post-contrast study. Results: Ten cases were confirmed as recurrent malignant lesions. After contrast administration, they all exhibited irregular T1 hypodense lesions of variable morphology with diffusion restriction and positive enhancement. Eight cases displayed a type III curve, while two showed a type II curve. Histopathological assessment was consistent with the MRI findings in all eight cases. The combination of the data produced by DWI-MRI and dynamic contrast enhanced (DCE)-MRI resulted in 100%sensitivity, 92.5% specificity, 90.9% positive predictive value, 100% negative predictive value, and 98% accuracy. Conclusion: Combination of DWI-MRI and DCE-MRI could have high diagnostic value for evaluating postoperative changes in patients with TNBC after BCS, followed by radiotherapy with/without chemotherapy.Trial Registrations: not trial to be registered

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Section: Discussionsupporting

confidence: 94%

WITHDRAWN: Assessment of Suspected Breast Lesions in Early Stage Triple Negative Breast Cancer During Follow-up After Breast Conserving Surgery Using Multiparmetric MRI

Sad¹,

Dabees²,

Mohamed³

et al. 2020

Preprint

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“…Some studies had questioned the value of DWI and ADC and discovered that it is a beneficial tool in lesion characterization and even in treatment monitoring and planning. ADC values showed strong correlation with lesion histology being notably lower in malignant lesions; also, the highest values were recorded in human epidermal growth factor receptor (HER2)-enriched tumors, while low ADC had suggested progesterone receptor (PR) negativity [11,21]. Additionally, we found that lesion signal intensity in T2WI was a helpful indicative of its nature, as most of malignant lesions were hypointense in T2WI, opposing most benign lesions which displayed high signal intensity.…”

Section: Discussionmentioning

confidence: 90%

Unenhanced breast MRI: could it replace dynamic breast MRI in detecting and characterizing breast lesions?

Khalil

Osman

Chalabi

et al. 2020

Egypt J Radiol Nucl Med

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Background: We aimed to evaluate the unenhanced MRI of the breast (UE-MRI) as an effective substitute for dynamic contrast-enhanced breast MRI (DCE-MRI) in both detecting and characterizing breast lesions. We enrolled in our retrospective study 125 females (232 breasts, as 18 patients had unilateral mastectomy) with breast mass at MRI of variable pathologies. Routine DCE-MRI protocol of the breast was conducted. We compared the conventional unenhanced images including STIR, T2, and DWIs to the DCE-MRI by two blinded radiologists, to detect and characterize breast lesions, and then we compared their results with the final reference diagnoses supplied by the histopathology or serial negative follow-ups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for UE-MRI and DCE-MRI were calculated. UE-MRI results of each observer were also compared with DCE-MRI. Results: The calculated UE-MRI sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for the first observer were 95%, 80%, 83%, 94%, and 89% respectively, and for the second observer, they were 94%, 79%, 81%, 93%, and 86%. On the other hand, those for the DCE-MRI by the first observer were 98%, 82%, 84%, 98%, and 90% and were 97%, 81%, 84%, 97%, and 89% by the second observer. The intraobserver agreement between the UE-MRI and DCE-MRI results of each observer was 94% and 95%, while the interobserver agreement for each section was 97.4% for UE-MRI and 98.3% for DCE-MRI. Conclusion: UE-MRI of the breast can be a reliable and effective substitute for breast DCE-MRI. It can be used with comparable accuracy to DCE-MRI whenever contrast administration is not feasible or contraindicated.

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“…Tumor heterogeneity may also influence quantitative imaging parameters when they are analyzed from either the volume of the tumor or the peritumoral area. The molecular effects of the receptor status on tumor angiogenesis and cellularity may also be inconsistent among lesions despite an identical receptor status, as the result of other unmeasured factors [31]. Therefore, to minimize the effects of the factors that confound DWI, we documented the "worst region of interest" by using small ROIs specifically placed where the ADC values appeared to be most reduced inside the tumor and most increased adjacent to the tumor border.…”

Section: Plos Onementioning

confidence: 99%

Peritumor to tumor apparent diffusion coefficient ratio is associated with biologically more aggressive breast cancer features and correlates with the prognostication tools

et al. 2020

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The apparent diffusion coefficient (ADC) is increasingly used to characterize breast cancer. The peritumor/tumor ADC ratio is suggested to be a reliable and generally applicable index. However, its overall prognostication value remains unclear. We aimed to evaluate the associations between the peritumor/tumor ADC ratio and histopathological biomarkers and published prognostic tools in patients with invasive breast cancer. Materials and methods This prospective study included 88 lesions (five bilateral) in 83 patients with primary invasive breast cancer who underwent preoperative 3.0-T magnetic resonance imaging. The lowest intratumoral mean ADC value on the slice with the largest tumor cross-sectional area was designated the tumor ADC, and the highest mean ADC value on the peritumoral breast parenchymal tissue adjacent to the tumor border was designated the peritumor ADC. The peritumor/tumor ADC ratio was then calculated. The tumor and peritumor ADC values and peritumor/tumor ADC ratios were compared with histopathological parameters using an unpaired t test, and their correlations with published prognostic tools were evaluated with Pearson's correlation coefficient. Results The peritumor/tumor ADC ratio was significantly associated with tumor size (p<0.001), histological grade (p = 0.005), Ki-67 index (p = 0.006), axillary-lymph-node metastasis

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The role of diffusion weighted imaging as supplement to dynamic contrast enhanced breast MRI: Can it help predict malignancy, histologic grade and recurrence?

Cited by 24 publications

References 32 publications

WITHDRAWN: Assessment of Suspected Breast Lesions in Early Stage Triple Negative Breast Cancer During Follow-up After Breast Conserving Surgery Using Multiparmetric MRI

WITHDRAWN: Assessment of Suspected Breast Lesions in Early Stage Triple Negative Breast Cancer During Follow-up After Breast Conserving Surgery Using Multiparmetric MRI

Unenhanced breast MRI: could it replace dynamic breast MRI in detecting and characterizing breast lesions?

Peritumor to tumor apparent diffusion coefficient ratio is associated with biologically more aggressive breast cancer features and correlates with the prognostication tools

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