A Prospective Study on the Role of Diffusion Weighted MR Imaging in Charcterisation of Breast Masses
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2016, Vol 5, Issue 4
Abstract
ABSTRACT Introduction: Breast MRI has been widely used for the detection, diagnosis and staging of breast cancer. Even though lower ADC, which is the objective measure of the diffusivity has been proved too strongly associated with malignant tumours, the threshold ADC value which best differentiates these lesions is not yet standardized. Aim: To identify the appropriate cut-off value for ADC value to diagnose malignant breast lesions in Indian women. Materials and Methods: A total of 55 lesions, in patients presenting with clinically palpable breast lump, mammographically or sonographically detected breast masses, were included in the study. MRI was done, using dedicated phased-array breast coil. Routine MRI sequences and dynamic contrast enhanced MRI was done in addition to the DWI sequence (b- values of 0 & 1000 s/ mm2). ADC value of each of the breast lump was acquired. Histological confirmation was done by trucut biopsy/ excision biopsy of the lumps and was considered to be the gold standard. Results: The area under ROC curve was close to highest possible value of 1 (AUC=0.997, 95% CI 0.98 to 1, p value < 0.001), indicating high predictive validity of ADC. The best sensitivity (96.2%) and specificity (100%) were observed for an ADC cut off value of 1.31 in study population. When slightly lower cut off value of 1.15 is considered the sensitivity remained at 96.2 but specificity has declined to 99.97%. When slightly higher cut off of 1.42 is considered, the sensitivity has declined to 93% with specificity remaining at 100%. Conclusion: DWI using cut-off ADC value is a promising MRI technique which could improve the diagnostic accuracy of the breast MRI in lesion characterization. It could prove to be an useful adjunct to the established DCEMRI. More validated studies are required to standardize the DWI protocol, optimize the b-values and to determine the optimum cut-off ADC values.
Authors and Affiliations
Rajalakshmi Preethi G, Mariappan Murugan, Mahesh K Mitttal, Brij Bhushan Thukral
Keywords
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- EP ID EP481045
- DOI 10.7860/IJARS/2016/23252:2217
- Views 127
- Downloads 0
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