Journal Article

Peritumoral apparent diffusion coefficients for prediction of lymphovascular invasion in clinically node-negative invasive breast cancer

Takasawa, Chiaki, Mugikura, Shunji, Ota, Hideki, Takase, Kei, kasajima, Atsuko, Ishida, Takanori, Takahashi, Shoki, Miyashita, Minoru, Mori, Naoko, Shimauchi, Akiko, Kodama, Tetsuya

2016

نظرة عامة

Objectives To evaluate whether visual assessment of T2-weighted imaging (T2WI) or an apparent diffusion coefficient (ADC) could predict lymphovascular invasion (LVI) status in cases with clinically node-negative invasive breast cancer. Materials and methods One hundred and thirty-six patients with 136 lesions underwent MRI. Visual assessment of T2WI, tumour-ADC, peritumoral maximum-ADC and the peritumour-tumour ADC ratio (the ratio between them) were compared with LVI status of surgical specimens. Results No significant relationship was found between LVI and T2WI. Tumour-ADC was significantly lower in the LVI-positive ( n  = 77, 896 ± 148 × 10 −6  mm 2 /s) than the LVI-negative group ( n  = 59, 1002 ± 163 × 10 −6  mm 2 /s; p  < 0.0001). Peritumoral maximum-ADC was significantly higher in the LVI-positive (1805 ± 355 × 10 −6  mm 2 /s) than the LVI-negative group (1625 ± 346 × 10 −6  mm 2 /s; p  = 0.0003). Peritumour-tumour ADC ratio was significantly higher in the LVI-positive (2.05 ± 0.46) than the LVI-negative group (1.65 ± 0.40; p  < 0.0001). Receiver operating characteristic curve analysis revealed that the area under the curve (AUC) of the peritumour-tumour ADC ratio was the highest (0.81). The most effective threshold for the peritumour-tumour ADC ratio was 1.84, and the sensitivity, specificity, positive predictive value and negative predictive value were 77 % (59/77), 76 % (45/59), 81 % (59/73) and 71 % (45/63), respectively. Conclusions We suggest that the peritumour-tumour ADC ratio can assist in predicting LVI status on preoperative imaging. Key points • Tumour ADC was significantly lower in LVI-positive than LVI-negative breast cancer. • Peritumoral maximum-ADC was significantly higher in LVI-positive than LVI-negative breast cancer. • Peritumour-tumour ADC ratio was significantly higher in LVI-positive breast cancer. • Diagnostic performance of the peritumour-tumour ADC ratio was highest for positive LVI. • Peritumour-tumour ADC ratio showed higher diagnostic ability in postmenopausal than premenopausal patients.

• الناشر: Springer Berlin Heidelberg,Springer Nature B.V
• موضوع: Adult / Aged / Area Under Curve / Biopsy / Breast / Breast cancer / Breast Neoplasms - pathology / Diagnostic Radiology / Diffusion Magnetic Resonance Imaging - methods / Edema / Female / Humans / Image Interpretation, Computer-Assisted - methods / Imaging / Internal Medicine / Interventional Radiology / Lymphatic Metastasis / Lymphatic system / Lymphatic Vessels - pathology / Magnetic resonance imaging / Medicine / Medicine & Public Health / Middle Aged / Neoplasm Invasiveness / Neuroradiology / Observer Variation / Radiology / Retrospective Studies / ROC Curve / Sensitivity and Specificity / Tumors / Ultrasound / University graduates