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Role of diffusion-weighted MRI: predicting axillary lymph node metastases in breast cancer

Title
Role of diffusion-weighted MRI: predicting axillary lymph node metastases in breast cancer
Authors
Chung, JinYouk, Ji HyunKim, Jeong-AhGweon, Hye MiKim, Eun-KyungRyu, Young HoonSon, Eun Ju
Ewha Authors
정진
SCOPUS Author ID
정진scopus
Issue Date
2014
Journal Title
ACTA RADIOLOGICA
ISSN
0284-1851JCR Link1600-0455JCR Link
Citation
vol. 55, no. 8, pp. 909 - 916
Keywords
Breast cancermagnetic resonance imaging (MRI)diffusionapparent diffusion coefficient (ADC)axillary lymph nodeultrasound (US)
Publisher
SAGE PUBLICATIONS LTD
Indexed
SCI; SCIE; SCOPUS WOS
Abstract
Background Ultrasound (US) is probably the standard imaging procedure in most centers, and US-guided fine needle aspiration can be added if suspicious lymph nodes are found. However, US-guided fine needle aspiration is an invasive method to diagnose a metastasis and has showed relatively low sensitivity. In general, diffusion-weighted (DW) magnetic resonance imaging (MRI) has become an emerging technique for discriminating benign from malignant breast lesions in a short imaging acquisition time. Purpose To evaluate the potential for using DW MRI with an apparent diffusion coefficient (ADC) value to predict axillary lymph node metastases in patients with invasive breast cancer. Material and Methods This study enrolled 110 axillary lymph nodes from 110 consecutive women who were diagnosed with invasive breast cancer for preoperative breast MRI and US. The largest enhancing ipsilateral axillary lymph nodes were included in this study, and benign and metastatic axillary lymph nodes were compared according to the pathologic reports. The cut-off ADC value to differentiate between benign and metastatic axillary lymph nodes was evaluated with receiver-operating characteristic curve analysis. Diagnostic performance of ultrasound and DW MRI was calculated for enhancing lymph node in dynamic contrast-enhanced MRI. Results Nodal metastases were documented in 68 (62%) axillary lymph nodes. The mean size of metastatic axillary lymph nodes was larger than that of benign axillary lymph nodes (15.5mm vs. 10.9mm, P<0.001). The mean ADC value (0.69x10(-3)mm(2)/s) of the metastases was significantly lower than that of the benign axillary lymph nodes (1.04x10(-3)mm(2)/s) (P<0.001). The ADC value cut-off between metastatic and benign axillary lymph nodes was 0.90x10(-3)mm(2)/s. Using ADC cut-off, sensitivity, specificity, and accuracy of DW MRI were 100%, 83.3%, and 93.6%, respectively. The sensitivity, specificity, and accuracy of US showed 94.1%, 54.8%, and 79.1%, respectively. Conclusion DW MRI of axillary lymph nodes can provide reliable information for the differentiation of benign from metastatic axillary lymph nodes in invasive breast cancer patients.
DOI
10.1177/0284185113509094
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의학전문대학원 > 의학과 > Journal papers
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