AI Summary & Key Takeaways
AI InsightWe suggest the routine use of DWI in breast MRI.
📌 3 Key Takeaways
Abstract
Purpose: The purpose of this study is to investigate the role of diffusion- weighted magnetic resonance imaging (MRI) in differentiation of benign and malignant breast lesions. Materials and Methods: A total of 40 breast lesions (28 benign, 12 malig- nant) were scanned by routine dynamic contrast-enhanced MRI and diffusion weighted imaging (DWI). The apparent diffusion coefficient (ADC) values of the lesions and normal breast tissue were measured and compared between benign and malignant groups. Also, lesions in benign and malignant groups were seperated according to dynamic contrast enhancement patterns and ADC values were compared. The results were evaluated at different cut-off values by receiver operating characteristic (ROC) curve analysis. Results: The mean ADC values were calculated as 0.83 ± 0.3x10-3 mm2/s in malignant lesions, and 1.35 ± 0.2 x10-3 mm2/s in benign lesions. The mean ADC value of the malignant lesions was statistically significantly lower than that of the benign lesions (p<0.001). The mean ADC value of normal fibrog- landular tissue was significantly lower in malignant group than that of be- nign group (p<0.001). When the lesions were seperated according to contrast enhancement – time curves, there were type 1 (n=19), type 2 (n=7) and type 3 (n=1) lesions in benign group and type 2 (n=5) and type 3 (n=7) lesions in malignant group. There was no contrast enhancement in one lesion in the benign group. No significant difference was found between the ADC values of type 1 and type 2 lesions in benign group and type 2 and type 3 lesions in malignant group (p>0.05). In ROC curve analysis, when the cut-off value was taken as 1.01 ± 0.25x10-3 mm2/s (b=1000), the sensitivity was 92.3%, the specificity was 92.5%, and the positive predictive value (PPV) was 85.7%. Conclusions: In differentiation of benign and malignant breast lesions, ADC value is a helpful parameter, that could be used together with the morpho- logical criteria and the dynamic contrast enhancement pattern of the lesions. We suggest the routine use of DWI in breast MRI.
Özet
Amaç: Bu çalışmanın amacı, difüzyon ağırlıklı manyetik rezonans görüntül- emenin (MRG) benign ve malign meme lezyonlarının ayrımındaki yerinin araştırılmasıdır. Gereç ve Yöntem: Toplam 40 meme lezyonuna (28 benign, 12 malign) yöne- lik rutin kontrastlı dinamik MRG ve difüzyon ağırlıklı görüntüleme (DAG) uygulandı. Lezyonların ve normal meme dokusunun “apparent diffusion coefficient” (ADC) değerleri ölçülerek benign ve malign gruplar arasında karşılaştırıldı. Ayrıca, malign ve benign gruplardaki lezyonlar dinamik kon- trastlanma paternlerine göre ayrılarak ADC değerleri karşılaştırıldı. Sonuçlar, farklı eşik değerlerinde “receiver operating characteristic” (ROC) eğrisi analizi ile değerlendirildi. Bulgular: Malign lezyonların ortalama ADC değeri 0.83 ± 0.3x10-3 mm2/s; benign lezyonların 1.35 ± 0.2x10-3 mm2/s olarak hesaplandı. Malign lezyonların ortalama ADC değeri, benign lezyonların ortalama ADC değerinden istatiksel anlamlı olarak düşüktü (p 0.05). ROC eğrisi analizinde, eşik değeri 1.01 ± 0.25x10-3 mm2/s (b=1000) kabul edildiğinde duyarlılık %92.3, özgüllük %92.5 ve pozitif öngörü değeri (PPV) %85.7 olarak bulundu. Sonuç: Benign ve malign meme lezyonlarının ayırt edilmesinde ADC değeri, morfolojik kriterler ve lezyonların dinamik kontrastlanma eğrileri ile birlikte kullanılabilecek yardımcı bir parametredir. DAG’nin meme MRG’sinde rutin olarak kullanılmasını önermekteyiz.