Does Normalised Apparent Diffusion Coefficient Further Improve the Diagnostic Accuracy of Diffusion-Weighted MRI at 3T in Characterising Breast Masses?
Journal Title: Journal of Clinical and Diagnostic Research - Year 2019, Vol 13, Issue 4
Abstract
ABSTRACT Introduction: In recent times, a significant rise has been observed in the incidence of breast cancer among Indian women. Breast Magnetic Resonance Imaging (MRI) plays an adjuvant role in the high risk screening, diagnosis, staging and follow-up of breast cancer. It is used as a complementary tool to mammography and ultrasound for the diagnostic work-up of breast masses. An advanced MRI technique such as Diffusion-Weighted Imaging (DWI) with quantitative absolute and normalised Apparent Diffusion Coefficient (ADC) measurements is employed to improve the diagnostic performance of Contrast-Enhanced Breast MRI (CE-MRI). Aim: To assess whether glandular tissue-normalised Apparent Diffusion Coefficient (nADC) could further improve the diagnostic accuracy of MRI, in characterising benign versus malignant breast masses. Materials and Methods: This cross-sectional study included 39 patients with 51 focal breast masses. These patients underwent CE-MRI and DWI, on a 3T MR system. Absolute ADC values and glandular tissue-normalised ADC values were measured in the breast masses satisfying the inclusion criteria. The diagnostic accuracy and kappa measure of agreement between the diagnoses obtained from various imaging techniques (independently and in combination) and the final histopathology/follow-up results were calculated. Results: Twenty six (51%) of the 51 breast masses were benign and 25 (49%) were malignant. The mean nADC value (0.619+0.21×10−3 mm2/sec) obtained from malignant breast masses was significantly lower than the mean nADC value (0.98+0.26×10−3 mm2/sec) measured from benign breast masses (p<0.05). Adding, normalised ADC to CE-MRI, increased the specificity of breast MRI in differentiating benign from malignant breast masses, from 88.5% to 92.3% and improved its kappa score of agreement with histopathology or follow-up results, from 0.883 to 0.960. Receiver Operating Characteristic (ROC) curve analysis indicated that the Area Under Curve (AUC) for nADC (0.870) was higher than the AUC for absolute ADC (0.809). Conclusion: Quantitative DWI with glandular tissue-normalised ADC mapping at 3T, improves the diagnostic performance of breast MRI in characterising breast masses; especially in a subset of masses with borderline CE-MRI findings and absolute ADC values.
Authors and Affiliations
Varsha S Hardas, Aparna H Chandorkar, Aparna A Atre
Keywords
Related Articles
- EP ID EP554796
- DOI 10.7860/JCDR/2019/40523.12800
- Views 69
- Downloads 0
A Prospective Study to Compare the Functional and Aesthetic Outcomes with and without Primary Bone Grafting in Facial Fractures
Introduction: Open Reduction and Internal Fixation (ORIF) has been the gold standard in treatment of facial fractures. Bone grafts have been used to correct bone defects in face. Many studies assessing outcomes of ORIF a...
Molecular Investigation of a Suspected Myeloproliferative Neoplasm in Patients with Basophilia
Letter to Editor
Comparison of Continuous Femoral Nerve Block versus Local Infiltration Analgesia as a Postoperative Analgesia in Unilateral Total Knee Arthroplasty
Introduction: Local infiltration of knee joint in arthroplasty, provide postoperative analgesia and preserves motor power of quadriceps, which helps in early mobilisation, as compared to femoral nerve block which paralys...
Isolation of the Rare Opportunistic Yeast Saprochaete capitata from Clinical Samples-Experience from a Tertiary Care Hospital in Southern India and a Brief Review of the Literature
Introduction: Saprochaete capitata (Teleomorph: Magnusiomyces capitatus) is a ubiquitous yeast found in environmental sources such as soil, water, air, plants and dairy products. It is also a part of the normal microbial...
Atlantooccipital Fusion: Prevalence and its Developmental and Clinical Correlation
Introduction: Atlantooccipital fusion or occipitalization of atlas or assimilation of atlas is a rare or uncommon abnormality recorded in anatomical, morphological and radiological studies. It is usually associated with...