Role of MR DWIBS sequences for the evaluation of neoplastic breast disease

Congress:

ECR 2013

Poster Number:

C-1320

Type:

Scientific Exhibit

Keywords:

Breast, Oncology, MR, MR-Diffusion/Perfusion, Imaging sequences, Computer Applications-Detection, diagnosis, Neoplasia, Tissue characterisation

Authors:

M. Moschetta, L. Rella, M. Telegrafo, A. Scardapane, A. A. A. Stabile Ianora, G. Angelelli; Bari/IT

DOI:

10.1594/ecr2013/C-1320

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-1320

Fig. 1: Transverse DWIBS (A) and contrast-enhanced dynamic THRIVE (B) sequences from a...

Fig. 3: Transverse T2 (A) and DWIBS (B) sequences from a 52-year-old patient. Multiple...

Fig. 2: ADC map of the same case of Figure 1 (invasive ductal carcinoma) showing low...

Purpose

To investigate the role of diffusion-weighted MR imaging with background body signal suppression (DWIBS) for the evaluation of neoplastic breast disease.

Methods and Materials

90 patients underwent MR examination with a 1.5 T device and a dedicated 4-channel coil by using morphological STIR and TSE T2 sequences, dynamic THRIVE T1-weighted sequences after contrast material injection and DWIBS (b0 = 0 s/mm2, b1 = 1000 s/mm2). DWIBS images were analyzed by two expert blinded radiologists, searching for the presence of breast lesions and calculating the relative ADC value. A value of ADC ≤ 1.44x10-3 mm2/s was considered suspicious for malignancy. This analysis was then compared with dynamic images and histological...

Results

In 56/90 (62%) patients, DWIBS sequences indicated the presence of breast lesions, 19 (34%) with ADC values of >1.44x10-3 mm2/s and 37 (66%) with ADC of ≤1.44x10 -3 mm2/s. The comparison with the dynamic and histological examinations showed 25 malignant (Figs. 1-2) and 12 benign lesions (Fig. 3). DWIBS sequences obtained sensitivity, specificity, diagnostic accuracy, PPV and NPV values of 100, 82, 87, 68 and 100%, respectively. The agreement between the two readers was almost perfect (k = 0.85).

Conclusion

DWIBS sequences can be proposed in the MRI protocol for the study of the mammary gland and represent an accurate diagnostic complement, although not yet able to avoid the use of histological typing.

References

Degani H, Gusis V, Weinstein D, Fields S, Strano S. Mapping pathophysiological features of breast tumors by MRI at high spatial resolution. Nat Med 1997; 3:780–782. Orel SG. High-resolution MR imaging for the detection, diagnosis, and staging of breast cancer. RadioGraphics 1998; 18:903–912 Vestito A, Mangieri FF, Gatta G, Moschetta M, Turi B, Ancona A. Breast carcinoma in elderly women. Our experience. G Chir. 2011; 32:411-6. Belli P, Costantini M, Bufi E, Magistrelli A, La Torre G, Bonomo L. Diffusion-weighted imaging in breast lesion evaluation....

Personal Information

Marco Moschetta MD DIM - Interdisciplinary Department of Medicine Section of Diagnostic Imaging University of Bari Medical School Italy [email protected]