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Quantitative diffusion imaging in breast cancer: A clinical prospective study
Author(s) -
Rubesova Erika,
Grell AnneSophie,
De Maertelaer Viviane,
Metens Thierry,
Chao ShihLi,
Lemort Marc
Publication year - 2006
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20643
Subject(s) - medicine , effective diffusion coefficient , receiver operating characteristic , radiology , diffusion mri , breast cancer , nuclear medicine , magnetic resonance imaging , gold standard (test) , cancer
Abstract Purpose To study the correlation between apparent diffusion coefficient (ADC) and pathology in patients with undefined breast lesion, to validate how accurately ADC is related to histology, and to define a threshold value of ADC to distinguish malignant from benign lesions. Materials and Methods Seventy‐eight patients (110 lesions) were referred for positive or dubious findings. Three‐dimensional fast low‐angle shot (3D‐FLASH) with contrast injection was applied. EPI diffusion‐weighted imaging (DWI) with fat saturation was performed, and ROIs were selected on subtraction 3D‐FLASH images before and after contrast injection, and copied on an ADC map. Inter‐ and intraobserver analyses were performed. Results At pathology 22 lesions were benign, 65 were malignant, and 23 were excluded. The ADCs of malignant and benign lesions were statistically different. In malignant tumors the ADC was (mean ± SEM) 0.95 ± 0.027 × 10 –3 mm 2 /second, and in benign tumors it was 1.51 ± 0.068 × 10 −3 mm 2 /second. According to receiver operating characteristic (ROC) curves, we found a threshold between malignant and benign lesions for highest sensitivity and specificity (both 86%) around 1.13 ± 0.10 × 10 −3 mm 2 /second. For a threshold of 0.95 ± 0.10 × 10 −3 mm 2 /second, specificity was 100% but sensitivity was very low. Inter‐ and intraobserver studies showed good reproducibility. Conclusion The ADC may help to differentiate benign and malignant lesions with good specificity, and may increase the overall specificity of breast MRI. J. Magn. Reson. Imaging 2006. © 2006 Wiley‐Liss, Inc.

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