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Objective For more than two decades mammography has been used as the standard tool for the screening and diagnosis of breast cancer. However it has low specificity and hence patients have to undergo biopsies which is costly and associated with complications. Also sensitivity of mammography decreases considerably in young female patients with dense fibroglandular tissue. Magnetic resonance imaging (MRI)is playing a growing role in breast cancer detection,particularly for screening patients at high risk for cancer. The main goal of this study is to show value of diffusion-weighted MRI (DWI)and dynamic-contrast enhanced (CDE)MRI in the diagnosis of breast cancer. MethodsDWI and DCE-MRI examinations performed from January 2011 to December 2011 were retrospectively reviewed. Lesions were included in the study only if benign or malignant outcome could be definitively confirmed through tissue acquisition or linkage to a tumour registry. ResultsThe mean apparent diffusion coefficients (ADC)of malignant lesions was (0.94±0.25)×10-3mm2/s (range,0.20 - 1.43×10-3mm2/)and for benign lesions the value was (1.40±0.35)×10-3mm2/s (range,0.590 - 1.980 ×10-3mm2/s). receiver operating characteristic (ROC)analysis revealed that the area under the curve was 0.861 and the cut-off value for ADC was 1.105×10-3mm2/s. At this value for ADC,the MRI protocol was found to have a sensitivity of 76%,specificity of 78%,and positive predictive value of 11.3% and negative predictive value of 12.9%. On evaluation of the kinetic curves generated,it was found that 18.5% of the lesions with a type 1 kinetic curve were found to be malignant,81.8% of the lesions with a type II kinetic curve were malignant while 83.3% of the lesions with a type III kinetic curve were malignant. ConclusionMalignant lesions have significantly lower ADC values than benign lesions. The threshold ADC value between malignant and benign lesions is found to be 1.105×10-3mm2/s,with a sensitivity of 76% and specificity of 78%. Our study also demonstrates that type II and type III curves should be considered indicative of malignancy.
Objective it more than two decades mammography has been used as the standard tool for the screening and diagnosis of breast cancer. However sensitivity has mageography used considerably as in Magnetic resonance imaging (MRI) is playing a growing role in breast cancer detection, particularly for screening patients at high risk for cancer. The main goal of this study is to show the value of diffusion-weighted MRI ( DWI) and dynamic-contrast enhanced (CDE) MRI in the diagnosis of breast cancer. Methods DWI and DCE-MRI examinations performed from January 2011 to December 2011 were retrospectively reviewed. Lesions were included in the study only if benign or malignant outcome could be definitively confirmed through tissue acquisition or linkage to a tumor registry. ResultsThe mean apparent diffusion coefficients (ADC) of (0.94 ± 0.25) × 10-3mm2 / s (range, 0.20 - 1.43 × 10-3mm2 /) and for benign lesions the value was (1.40 ± 0.35) × 10-3mm2 / s × 10-3mm2 / s). Receiver operating characteristic (ROC) analysis revealed that the area under the curve was 0.861 and the cut-off value for ADC was 1.105 × 10-3mm2 / s. At this value for ADC, the MRI protocol was found to have a sensitivity of 76%, specificity of 78%, and positive predictive value of 11.3% and negative predictive value of 12.9%. On evaluation of the kinetic curves generated, it was found that 18.5% of the lesions with a type 1 kinetic curve were found to be malignant, 81.8% of the lesions with a type II kinetic curve were malignant while 83.3% of the lesions with a type III kinetic curve were malignant. Conclusion Malignant lesions have significantly lower lower ADC values than benign lesions. The threshold ADC value between malignant and benign lesions was found to be 1.105 × 10 -3 mm 2 / s, with a sensitivity of 76% and specificity of 78% Our study also demonstrates that type II and type III curves should be considered indicative of malignancy.