Apparent diffusion coefficient mapping using diffusion-weighted MRI: Impact of background parenchymal enhancement, amount of fibroglandular tissue and menopausal status on breast cancer diagnosis Journal Article


Authors: Horvat, J. V.; Durando, M.; Milans, S.; Patil, S.; Massler, J.; Gibbons, G.; Giri, D.; Pinker, K.; Morris, E. A.; Thakur, S. B.
Article Title: Apparent diffusion coefficient mapping using diffusion-weighted MRI: Impact of background parenchymal enhancement, amount of fibroglandular tissue and menopausal status on breast cancer diagnosis
Abstract: Objectives: To investigate the impact of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT) and menopausal status on apparent diffusion coefficient (ADC) values in differentiation between malignant and benign lesions. Methods: In this HIPAA-compliant study, mean ADC values of 218 malignant and 130 benign lesions from 288 patients were retrospectively evaluated. The differences in mean ADC values between benign and malignant lesions were calculated within groups stratified by BPE level (high/low), amount of FGT (dense/non-dense) and menopausal status (premenopausal/postmenopausal). Sensitivities and specificities for distinguishing malignant from benign lesions within different groups were compared for statistical significance. Results: The mean ADC value for malignant lesions was significantly lower compared to that for benign lesions (1.07±0.21 x 10−3 mm2/s vs. 1.53±0.26 x 10−3 mm2/s) (p<0.0001). Using the optimal cut-off point of 1.30 x 10−3 mm2/s, an area under the curve of 0.918 was obtained, with sensitivity and specificity both of 87 %. There was no statistically significant difference in sensitivities and specificities of ADC values between different groups stratified by BPE level, amount of FGT or menopausal status. Conclusions: Differentiation between benign and malignant lesions on ADC values is not significantly affected by BPE level, amount of FGT or menopausal status. Key Points: • ADC allows differentiation between benign and malignant lesions.• ADC is useful for breast cancer diagnosis despite different patient characteristics.• BPE, FGT or menopause do not significantly affect sensitivity and specificity. © 2018 European Society of Radiology
Keywords: adult; aged; aged, 80 and over; middle aged; retrospective studies; young adult; sensitivity and specificity; diagnosis, differential; differential diagnosis; pathology; diagnostic imaging; breast neoplasms; retrospective study; breast tumor; premenopause; menopause; postmenopause; diffusion weighted imaging; diffusion magnetic resonance imaging; roc curve; receiver operating characteristic; parenchyma; breast density; procedures; very elderly; humans; human; female; parenchymal tissue
Journal Title: European Radiology
Volume: 28
Issue: 6
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2018-06-01
Start Page: 2516
End Page: 2524
Language: English
DOI: 10.1007/s00330-017-5202-4
PUBMED: 29330631
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 October 2018 -- Article in Press -- Source: Scopus
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