Keywords:
Breast, MR-Diffusion/Perfusion, Diagnostic procedure, Cancer
Authors:
H. Caylak1, N. Köse1, S. Bulut2; 1SİVAS/TR, 2Sivas/TR
DOI:
10.26044/ecr2019/C-0471
Results
Distribution of Histopathological Diagnosis of Lesions and BI-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 shows distribution 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
|
1
|
13
|
23
|
37
|
|
%
|
0,0%
|
2,7%
|
35,1%
|
62,2%
|
100,0%
|
|
Total
|
N
|
6
|
20
|
30
|
27
|
83
|
|
%
|
7,2%
|
24,1%
|
36,1%
|
32,5%
|
100,0%
|
|
ADC values for each ROI method:
Table 2 shows the mean (±sd) ADC values of benign and malignant lesions for two different ROI methods.
Significant differences in ADC values of benign and malignant breast lesions were observed in the whole lesion ROI (W-ROI) (p=0.001) and average of three small ROI that placed the most aggressive subregion(S-ROI) (p=0.001).
Table 2. Mean ADC values (x10-3 mm2/s) of malignant and benign lesions of W-ROI and S-ROI methods and p-values.
|
Lesion Character
|
Mean ADC (x10-3mm2/sn)
|
Std.
Deviation
|
Result
|
Benign
|
W-ROI
|
1,23
|
0,19
|
t=9,60
|
S-ROI
|
1,13
|
0,19
|
p=0,001*
|
Malign
|
W-ROI
|
0,89
|
0,19
|
t=8,08
|
S-ROI
|
0,78
|
0,16
|
p=0,001*
|
ROC analysis:
On Figure 3,
using ROI that covers whole lesion and applying a cut-off value of 1,058 x10-3mm2/sn achieved 82% sensitivity,
89,2% specificity .
Using average of three small ROI that placed the most aggressive sub-region and a cut-off value of 0,943x10-3mm2/sn achieved 85% sensitivity 89,2% specificity.
Table 3 shows the confidence intervals and area under curve for each ROI methods.
In 18 (85%) of the 21 non-malignant lesions that included in the BI-RADS category 4 and 5 on DCE MR,
the ADC values were above the cut-off value.
Table 3: Area under the curve for all ROIs and confidence interval.
|
Test Result Variable(s)
|
Area
|
Std.
Error
|
Asymptotic 95% Confidence Interval
|
Lower Bound
|
Upper Bound
|
W-ROI
|
0,895
|
0,037
|
0,822
|
0,968
|
S-ROI
|
0,912
|
0,035
|
0,843
|
0,980
|