Apparent Diffusion Coefficient values from Diffusion Weighted Imaging for Invasive Lobular Cancer of the breast

Congress:

ECR 2013

Poster Number:

C-0987

Type:

Scientific Exhibit

Keywords:

Pathology, Neoplasia, Cancer, Screening, Imaging sequences, Computer Applications-Detection, diagnosis, MR-Functional imaging, MR-Diffusion/Perfusion, MR, Oncology, Computer applications, Breast

Authors:

D. Tzias¹, E. O'flynn², S. allen¹, R. Wilson³; ¹london/UK, ²Sutton , Surrey/UK, ³Sutton/UK

DOI:

10.1594/ecr2013/C-0987

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-0987

Fig. 4: ADC map. The tumour is seen as a dark area of restricted diffusion...

Fig. 3: DWI at b=700. The tumour is seen as a bright area of restricted diffusion in...

Fig. 2: DCE-MRI. The tumour is seen as a mass with irregular margins and small...

Purpose

Purpose Invasive lobular cancer (ILC) accounts for 10-15% of all breast cancers. It is often difficult to diagnose mammographically as it tends to produce masses of relatively low radiographic opacity, similar to normal fibroglandular breast tissue. It has a unique histological growth pattern of non-cohesive cells that tend to infiltrate in thin strands only one cell in width (Indian filing) and may also be multifocal (more than one area of disease in one quadrant of the breast) or multicentric (more than one area of disease...

Methods and Materials

This study was approved by the local research ethics committee. 57 patients with biopsy proven invasive cancer (23 ILC, median age 54 years (range 30-72 years); 34 IDC, median age 49 years (range 31-77 years)) underwent breast DCE-MRI with DWI during 2011 on either a 1.5T Siemens Avanto MR scanner (Siemens Medical Systems, Erlangen, Germany) (n=42) or a 1.5T Philips Intera scanner (Philips Healthcare, Netherlands) (n=15). Both scanners used a 4 channel breast coil and single shot echoplanar diffusion-weighted sequence employing inversion recovery for fat...

Results

The ADCmean (x10-6mm2/s) value for ILC was 1137+/-410 and ADCmean for IDC was 1124+/-437. These are not significantly different (p=0.91) ( figure 5 ). ADCmin (ILC 354+/- 384, IDC 298+/-292) (p=0.56) and ADCmax (ILC 2100+/-642, IDC 1947+/-748) also showed no significant difference ((p=0.56) and (p=0.41) respectively).

Conclusion

Invasive lobular cancer has similar ADC values to invasive ductal carcinoma. These can serve as a baseline and can be used to facilitate diagnosis of ILC on DWI if used in conjunction with DCE-MRI.

References

1. Schelfout K, Van Goethem M, Kersschot E, Verslegers I, Biltjes I, Leyman P, Colpaert C, Thienpont L, Van den Haute J, Gillardin JP, Tjalma W, Buytaert P, De Schepper A. Preoperative breast MRI in patients with invasive lobular breast cancer. Eur Radiol. 2004 Jul;14(7):1209-16. 2. Trecate G, Tess JD, Vergnaghi D, Bergonzi S, Mariani G, Ferraris C, Musumeci R. Lobular breast cancer: how useful is breast magnetic resonance imaging? Tumori. 2001 Jul-Aug;87(4):232-8. 3. Chen X, Li WL, Zhang YL, Wu Q, Guo YM, Bai...

Personal Information

Dr Demitrios Tzias is a Radiology trainee with special interest in Breast Radiology, London, St George's training scheme. Dr Elizabeth O'Flynn is a Consultant Radiologist at the Royal Marsden and Senior Lecturer at the Institute of Cancer Research, London, Sutton. Dr Steve Allen is a Consultant Radiologist at the Royal Marsden, London. Dr Robin Wilson is a Consultant Radiologist at the Royal Marsden, London.