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Quantitative Diffusion-weighted Imaging As An Adjunct To Conventional Breast MRI For Improved Positive Predictive Value.

S. Partridge, Wendy B DeMartini, B. Kurland, P. Eby, S. White, C. Lehman
Published 2009 · Medicine

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OBJECTIVE The purpose of our study was to investigate whether adding diffusion-weighted imaging (DWI) to dynamic contrast-enhanced MRI (DCE-MRI) could improve the positive predictive value (PPV) of breast MRI. MATERIALS AND METHODS The retrospective study included 70 women with 83 suspicious breast lesions on DCE-MRI (BI-RADS 4 or 5) who underwent subsequent biopsy. DWI was acquired during clinical breast MRI using b = 0 and 600 s/mm(2). Apparent diffusion coefficient (ADC) values were compared for benign and malignant lesions. PPV was calculated for DCE-MRI alone (based on biopsy recommendations) and DCE-MRI plus DWI (adding an ADC threshold) for the same set of lesions. Results were further compared by lesion type (mass, nonmasslike enhancement) and size. RESULTS Of the 83 suspicious lesions, 52 were benign and 31 were malignant (11 ductal carcinoma in situ [DCIS], 20 invasive carcinoma). Both DCIS (mean ADC, 1.31 +/- 0.24 x 10(-3) mm(2)/s) and invasive carcinoma (mean ADC, 1.29 +/- 0.29 x 10(-3) mm(2)/s) exhibited lower mean ADC than benign lesions (1.70 +/- 0.44 x 10(-3) mm(2)/s, p < 0.001). Applying an ADC threshold of 1.81 x 10(-3) mm(2)/s for 100% sensitivity produced a PPV of 47% versus 37% for DCE-MRI alone, which would have avoided biopsy for 33% (17/52) of benign lesions without missing any cancers. DWI increased PPV similarly for masses and nonmasslike enhancement and preferentially improved PPV for smaller (< or = 1 cm) versus larger lesions. CONCLUSION DWI shows potential for improving the PPV of breast MRI for lesions of varied types and sizes. However, considerable overlap in ADC of benign and malignant lesions necessitates validation of these findings in larger studies.
This paper references
10.1002/jmri.10140
Differentiation of clinically benign and malignant breast lesions using diffusion‐weighted imaging
Y. Guo (2002)
10.1056/NEJMOA031759
Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition.
M. Kriege (2004)
10.1259/bjr.73.872.11026854
MRI of the breast.
S. Rankin (2000)
10.1016/j.amjsurg.2007.10.009
Breast magnetic resonance imaging for preoperative locoregional staging.
A. Hollingsworth (2008)
10.3322/canjclin.57.2.75
American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography
D. Saslow (2007)
10.1200/JCO.2007.15.2108
Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer.
N. Houssami (2008)
10.1016/S0887-2171(98)90027-0
Breast magnetic resonance imaging.
S. Harms (1998)
10.1016/J.EJRAD.2006.08.030
The American College of Radiology (ACR) Breast Imaging and Reporting Data System (BI-RADS): a step towards a universal radiological language?
D. Vanel (2007)
10.1002/jmri.20727
Correction of eddy‐current distortions in diffusion tensor images using the known directions and strengths of diffusion gradients
Jiancheng Zhuang (2006)
10.1056/NEJMOA065447
MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer.
C. Lehman (2007)
10.1001/JAMA.293.10.1245
Screening for Breast Cancer
J. Elmore (2005)
10.1002/jmri.21570
Enhanced mass on contrast‐enhanced breast MR imaging: Lesion characterization using combination of dynamic contrast‐enhanced and diffusion‐weighted MR images
H. Yabuuchi (2008)
10.1002/jmri.22389
Dynamic contrast‐enhanced magnetic resonance imaging and invasive breast cancer: Primary lesion kinetics correlated with axillary lymph node extracapsular extension
C. Loiselle (2011)
10.1002/jmri.20683
Artifacts and pitfalls in diffusion MRI
D. Le Bihan (2006)
10.2214/AJR.09.3534
Apparent diffusion coefficient values for discriminating benign and malignant breast MRI lesions: effects of lesion type and size.
S. Partridge (2010)
10.1016/J.ACRA.2007.06.006
Diffusion weighted imaging in breast MRI: comparison of two different pulse sequences.
E. Wenkel (2007)
10.1016/j.acra.2007.12.020
The effect of susceptibility of gadolinium contrast media on diffusion-weighted imaging and the apparent diffusion coefficient.
A. Ogura (2008)
10.1016/S0033-8389(01)00017-3
Breast imaging reporting and data system (BI-RADS).
L. Liberman (2002)
10.1007/s11604-007-0128-4
Comparison of breast cancer detection by diffusion-weighted magnetic resonance imaging and mammography
Miho I. Yoshikawa (2007)
10.1002/(SICI)1522-2594(199909)42:3<515::AID-MRM14>3.0.CO;2-Q
Optimal strategies for measuring diffusion in anisotropic systems by magnetic resonance imaging
D. K. Jones (1999)
10.1007/s00234-003-0965-5
Echoplanar diffusion-weighted MRI with intravenous gadolinium-DTPA
C. Fitzek (2003)
10.1002/(SICI)1522-2586(199901)9:1<53::AID-JMRI7>3.0.CO;2-2
Usefulness of diffusion‐weighted MRI with echo‐planar technique in the evaluation of cellularity in gliomas
T. Sugahara (1999)
10.2214/AJR.09.4108
Predictive value for malignancy of suspicious breast masses of BI-RADS categories 4 and 5 using ultrasound elastography and MR diffusion-weighted imaging.
H. Satake (2011)
10.2463/MRMS.9.217
Diagnostic performance of ADC for Non-mass-like breast lesions on MR imaging.
T. Imamura (2010)
10.1016/j.rcl.2010.06.011
Breast MR imaging: current indications and advanced imaging techniques.
S. Weinstein (2010)
10.1148/RADIOL.2442060461
Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study.
C. Lehman (2007)
10.1016/j.ejrad.2010.03.009
Diffusion and perfusion of the breast.
C. Iacconi (2010)
10.1002/JSO.20381
MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883
M. Schnall (2005)
10.1002/1522-2594(200006)43:6<828::AID-MRM8>3.0.CO;2-P
Measurement of cell density and necrotic fraction in human melanoma xenografts by diffusion weighted magnetic resonance imaging
H. Lyng (2000)
10.1002/jmri.10116
In vivo diffusion‐weighted MRI of the breast: Potential for lesion characterization
S. Sinha (2002)
10.3348/kjr.2007.8.5.390
The Role of Diffusion-Weighted Imaging and the Apparent Diffusion Coefficient (ADC) Values for Breast Tumors
M. Park (2007)
10.2214/AJR.10.4258
Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of breast tumors.
S. Kul (2011)
10.1016/J.MRI.2005.02.015
Intravenous administration of Gd-DTPA prior to DWI does not affect the apparent diffusion constant.
G. Chen (2005)
10.1007/s00330-007-0621-2
Quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesion
C. Marini (2007)
10.1001/JAMA.292.11.1317
Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination.
E. Warner (2004)
Diffusion tensor MR imaging of the brain: effect of diffusion weighting on trace and anisotropy measurements.
E. Melhem (2000)
10.2463/MRMS.7.23
Apparent diffusion coefficients of breast tumors: clinical application.
M. Hatakenaka (2008)
10.3174/ajnr.A1052
Diffusion Tensor MR Imaging and Fiber Tractography: Technical Considerations
P. Mukherjee (2008)
10.1148/RADIOL.2212010280
Statistical issues in analysis of diagnostic imaging experiments with multiple observations per patient.
M. Gönen (2001)
10.1097/00004728-200211000-00033
Diffusion-Weighted Half-Fourier Single-Shot Turbo Spin Echo Imaging in Breast Tumors: Differentiation of Invasive Ductal Carcinoma from Fibroadenoma
T. Kinoshita (2002)
10.1002/mrm.22762
Improved diagnostic accuracy of breast MRI through combined apparent diffusion coefficients and dynamic contrast‐enhanced kinetics
S. Partridge (2011)
10.1148/RADIOL.2333031484
Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer.
W. Berg (2004)
10.1007/s11604-007-0187-6
Comparison of 3.0-and 1.5-tesla diffusion-weighted imaging in the visibility of breast cancer
Aoi Matsuoka (2007)
10.2214/AJR.159.3.1503032
Diffusion MR imaging: clinical applications.
D. Le Bihan (1992)
10.1002/JMRI.20643
Quantitative diffusion imaging in breast cancer: A clinical prospective study
E. Rubesova (2006)
10.2463/MRMS.4.35
ADC mapping of benign and malignant breast tumors.
R. Woodhams (2005)
10.1002/jmri.22400
Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma
S. K. Jeh (2011)



This paper is referenced by
10.1002/mrm.24824
Dynamic slice‐dependent shim and center frequency update in 3 T breast diffusion weighted imaging
S. Lee (2014)
10.1007/s00330-017-4898-5
Additional value of diffusion-weighted imaging to evaluate multifocal and multicentric breast cancer detected using pre-operative breast MRI
S. Song (2017)
10.1038/s41523-017-0045-3
Integrated radiomic framework for breast cancer and tumor biology using advanced machine learning and multiparametric MRI
V. Parekh (2017)
10.1002/mrm.25309
On conductivity, permittivity, apparent diffusion coefficient, and their usefulness as cancer markers at MRI frequencies
I. Hancu (2015)
10.1371/journal.pone.0087387
Diagnosis of Breast Masses from Dynamic Contrast-Enhanced and Diffusion-Weighted MR: A Machine Learning Approach
Hongmin Cai (2014)
Characteristics of malignant breast lesions on contrast enhanced MRI influence the apparent diffusion coefficient in diffusion-weighted imaging
M. Dorrius (2015)
10.1016/B978-0-323-05198-9.00007-X
Magnetic Resonance Imaging of Breast Cancer and MRI-Guided Breast Biopsy
B. Daniel (2011)
Investigating the introduction of spectroscopy and diffusion-weighted imaging (DWI) sequences to increase the specificity of breast magnetic resonance imaging (MRI)
Peter Oberlin-Brown (2013)
10.5152/dir.2015.14534
MRI features of breast lymphoma: preliminary experience in seven cases.
L. Wang (2015)
10.1111/tbj.12861
Contribution of diffusion‐weighted imaging to dynamic contrast‐enhanced MRI in the characterization of papillary breast lesions
S. Yildiz (2018)
Quantificação da Difusão na Ressonância Magnética da mama -ADC e Kurtosis-
Filipa Borlinhas (2012)
10.1177/0284185119896520
Diagnostic performance of whole-lesion apparent diffusion coefficient histogram analysis metrics for differentiating benign and malignant breast lesions: a systematic review and diagnostic meta-analysis
F. Xu (2020)
10.1016/j.ejrad.2010.03.009
Diffusion and perfusion of the breast.
C. Iacconi (2010)
Diffusion Weighted Magnetic Resonance Imaging of the Breast Optimization, Interpretation, and
Savannah C. Partridge (2013)
10.1053/j.sult.2011.02.007
Ductal carcinoma in situ: detection, diagnosis, and characterization with magnetic resonance imaging.
S. Jansen (2011)
Diffusion-weighted imaging in breast cancer characterization
G. Giardina (2012)
10.1007/s00330-014-3166-1
Computer-aided evaluation as an adjunct to revised BI-RADS Atlas: improvement in positive predictive value at screening breast MRI
Hye Mi Gweon (2014)
10.1016/J.EJRNM.2014.10.009
Role of diffusion weighted images combined with breast MRI in improving the detection and differentiation of breast lesions
W. Hetta (2015)
10.1007/s12609-016-0226-3
Advanced Breast MRI Techniques: Helpful for Screening Breast Cancer?
Jessica H Porembka (2016)
10.1007/s00330-014-3153-6
MRI-only lesions: application of diffusion-weighted imaging obviates unnecessary MR-guided breast biopsies
C. Spick (2014)
10.2214/AJR.13.11159
Diffusion-weighted MRI: association between patient characteristics and apparent diffusion coefficients of normal breast fibroglandular tissue at 3 T.
E. McDonald (2014)
10.1002/jmri.24416
High‐resolution diffusion‐weighted imaging for the separation of benign from malignant BI‐RADS 4/5 lesions found on breast MRI at 3T
D. Wisner (2014)
10.18632/oncotarget.22267
Prediction of low-risk breast cancer using quantitative DCE-MRI and its pathological basis
Tingting Xu (2017)
10.1002/mrm.25555
Microscopic diffusion properties of fixed breast tissue: Preliminary findings
N. Norddin (2015)
10.1002/jmri.26908
Diffusion MRI of the breast: Current status and future directions
M. Iima (2019)
10.1016/J.EJRNM.2017.10.015
The added value of qualitative and quantitative diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating benign from malignant breast lesions
Reham Ali Abd El-Aleem (2018)
10.1007/s00330-017-5202-4
Apparent diffusion coefficient mapping using diffusion-weighted MRI: impact of background parenchymal enhancement, amount of fibroglandular tissue and menopausal status on breast cancer diagnosis
J. V. Horvat (2017)
10.1007/s00259-019-04331-6
A multiparametric [18F]FDG PET/MRI diagnostic model including imaging biomarkers of the tumor and contralateral healthy breast tissue aids breast cancer diagnosis
D. Leithner (2019)
10.1016/j.crad.2020.03.039
Multiple b-value diffusion-weighted imaging in differentiating benign from malignant breast lesions: comparison of conventional mono-, bi- and stretched exponential models.
B-Y Chen (2020)
10.1016/j.acra.2013.10.001
Preoperative MRI improves prediction of extensive occult axillary lymph node metastases in breast cancer patients with a positive sentinel lymph node biopsy.
C. Loiselle (2014)
10.1016/j.mric.2010.09.001
Diffusion magnetic resonance imaging of the breast.
Fernanda Philadelpho Arantes Pereira (2011)
10.1007/978-1-4939-1267-4_9
Breast mri for diagnosis and staging of breast cancer
R. Khouli (2015)
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