Korean J Radiol.  2007 Oct;8(5):390-396. 10.3348/kjr.2007.8.5.390.

The Role of Diffusion-Weighted Imaging and the Apparent Diffusion Coefficient (ADC) Values for Breast Tumors

Affiliations
  • 1Department of Radiology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea. escha@catholic.ac.kr

Abstract


OBJECTIVE
We wanted to evaluate the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) for detecting breast tumors, as compared with the T1- and T2-weighted images. MATERIALS AND METHODS: Forty-one female patients underwent breast MRI, and this included the T1-, T2-, DWI and dynamic contrast-enhanced images. Sixty-five enhancing lesions were detected on the dynamic contrast-enhanced images and we used this as a reference image for detecting tumor. Fifty-six breast lesions were detected on DWI and the histological diagnoses were as follows: 43 invasive ductal carcinomas, one mucinous carcinoma, one mixed infiltrative and mucinous carcinoma, seven ductal carcinomas in situ (DCIS), and four benign tumors. First, we compared the detectability of breast lesions on DWI with that of the T1- and T2-weighted images. We then compared the ADCs of the malignant and benign breast lesions to the ADCs of the normal fibroglandular tissue. RESULTS: Fifty-six lesions were detected via DWI (detectability of 86.2%). The detectabilities of breast lesions on the T1- and T2-weighted imaging were 61.5% (40/65) and 75.4% (49/65), respectively. The mean ADCs of the invasive ductal carcinoma (0.89 +/- 0.18x10(-3)mm2/second) and DCIS (1.17 +/- 0.18x10(-3)mm2/ second) are significantly lower than those of the benign lesions (1.41 +/- 0.56x10(-3)mm2/second) and the normal fibroglandular tissue (1.51 +/- 0.29x10(-3)mm2/ second). CONCLUSION: DWI has a high sensitivity for detecting breast tumors, and especially for detecting malignant breast tumors. DWI was an effective imaging technique for detecting breast lesions, as compared to using the T1- and T2-weighted images.

Keyword

Diffusion-weighted imaging; Breast, MR; Breast, cancer; Detectability

MeSH Terms

Adenocarcinoma, Mucinous/*diagnosis
Adult
Aged
Breast/pathology
Breast Neoplasms/*diagnosis
Carcinoma, Ductal, Breast/*diagnosis
Carcinoma, Intraductal, Noninfiltrating/*diagnosis
Contrast Media/administration & dosage
Diffusion Magnetic Resonance Imaging/*methods
Female
Gadolinium DTPA/diagnostic use
Humans
Image Enhancement/methods
Imaging, Three-Dimensional/methods
Middle Aged
Observer Variation
Sensitivity and Specificity

Figure

  • Fig. 1 A 69-year-old woman with bilateral invasive ductal carcinoma. A.The axial T1-weighted image shows multiple lobular homogeneous iso-signal intensity masses in both breasts. B.The maximum-intensity projection of the subtraction image shows multiple enhancing masses in both breasts (thin white arrows and arrowhead). C.The axial diffusion weighted image shows multiple high-signal intensity masses in both breasts (thin white arrows), but tiny multicentric lesions are not detected in the left breast (white arrowhead). The apparent difusion coefficient value of the right breast tumor was 0.94 × 10-3mm2/second and that of the left breast tumor was 0.84 × 10-3mm2/second. D.The sagittal dynamic-enhanced T1-weighted gradient-echo substraction image of the first postcontrast acquisition shows multiple, heterogeneous, rim-enhancing masses in both breasts (thin white arrows and white arrowhead). The left side of this image represents the right breast and the right one represents the left breast. A tiny multicentric lesion is extremely well visualized in the left breast (white arrowhead).

  • Fig. 2 A 53-year-old woman with ductal carcinoma in situ. A.The axial T1-weighted image shows segmentally distributed, asymmetric, iso-signal intensity, non-mass lesion in the left breast. B.The maximal intensity projection of a subtraction image shows heterogeneous clumpy enhancement in the left breast. C.The diffusion-weighted image shows the main lesion to be a high-signal intensity lesion. D.The axial plane apparent diffusion coefficient map shows a mixed green and yellow area and the apparent diffusion coefficient value of this breast tumor was 1.43 × 10-3mm2/second.

  • Fig. 3 A 41-year-old woman with fibroadenoma that was confirmed by core-needle biopsy. A.The axial T1-weighted image shows a circumscribed oval iso-signal intensity mass in the right breast. B.The maximal intensity projection of the subtraction image shows homogeneous enhancement in the right breast. A nonspecific small enhancing nodule is also seen in the left breast. This left nodule showed typical benign features on the breast USG (not shown), so we did not perform core-needle biopsy. C.The diffusion-weighted image shows the mass to be a high-signal intensity lesion in the right breast. D.The axial plane apparent diffusion coefficient map shows the mixed yellow and red area, and the apparent diffusion coefficient value of this tumor was 1.63 × 10-3mm2/second.


Cited by  1 articles

Correlation of Prognostic Factors of Invasive Lobular Carcinoma with ADC Value of DWI and SUVMax of FDG-PET
Bo Bae Choi, Sung Hun Kim, Chang Suk Park, Na Young Jung
Chonnam Med J. 2017;53(2):133-139.    doi: 10.4068/cmj.2017.53.2.133.


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