Aims and objectives
Diffusion-Weighted Imaging (DWI) is a short,
non-contrast MRI method with the potential to increase specificity in addition to conventional breast MRI protocols (1,2).
The apparent diffusion coefficient (ADC) (Quantitative DWI) is a powerful imaging tool that provides unique information about the diffusion of water molecules in tissue,
predicting cellularity and structure (3).
In the clinic,
the current usage area of Breast DWI is to increase the accuracy of cancer diagnosis,
evaluate the effect of neo-adjuvant chemotherapy and guidance in the menagement of the treatment for...
Methods and materials
Patient Selection:
Between 01.09.2013 and 15.02.2018,
79 female patients who underwent Dynamic Contrast Enhanced (DCE) and DWI Breast MRI before biopsy or surgical operation with positive diagnosis at MG,
US and/or clinical findings were included in the study and studied retrospectively.Non-mass lesions and lesions smaller than 10 mm were not included in the study.Also the patients whom treated with neoadjuvant chemotherapy and radiotherapy were not included in the study.The minimum age of the patients in the study was 21 years,
the maximum age was 76...
Results
Distribution of Histopathological Diagnosis of Lesions andBI-RADS©categorization:
Benign lesions:19 fibroadenomas,
9 fibroadenomatoid hyperplasia,
9 fibrocystic changes,
4 granulomatous mastitis,
2 ductal papillomas,
2 stromal hyalinization,
1 adenosis;Malign lesions:33 Invasive ductal carcinoma (31 invasive carcinoma NST,1 Cribriform carcinoma,
1 tubulocribriform carcinoma),
4 ductal carcinoma in situ.Table 1 showsdistribution of lesion character and MR BI-RADS©Scores.
Table 1.Distribution of Lesion Character and MR BI-RADS©Scores
Lesion Character
BI-RADS
Total
2
3
4
5
Benign
N
6
19
17
4
46
%
13,0%
41,3%
37,0%
8,7%
100,0%
Malign
N
0...
Conclusion
It was observed that DWI achieved adequate sensitivity and specificity (85% and 89%) in the differentiation of benign and malignant breast lesions and decreased false positivity in combination with Dynamic Contrast MRI,
thereby it has potential to reducing the number of unnecessary biopsies and preventing unnecessary anxiety of patients.
Two different ROI placement methods had equal specificity but for sensitivity using S- ROI was a bit superior than W-ROI.These results should be validated in a larger group of breast lesions and in prospective study.
Personal information
Halil Caylak,
MD
Cumhuriyet University School of Medicine Radiology Department
Cumhuriyet University Campus,
58140,
SIVAS,
TURKEY
Phone: + 90 346 258 02 75 e-mail :
[email protected]
References
1.Parsian S,
Rahbar H,
Allison KH.
Non-malignant Breast lesions: ADCs of Benign and High-Risk Subtypes Assessed as False-Positive at Dynamic Enhanced MR Imaging Radiology:Volume 265: Number 3—Dec.
2012:696-706
2.Chen X,
Li W,
Zhang Y,
Meta-analysis of quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesions BMC Cancer 2010,
10:693
3.Koh DM,
Collins DJ.
Diffusion-weighted MRI in the body: applications and challenges in oncology.
AJR Am J Roentgenol 2007;188(6):1622–1635.
4..Partridge S,
Amornsiripanitch N.
DWI in the Assessment of Breast Lesions Topics in Magnetic Resonance...
