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The Diagnostic Value of Diffusion Weighted Imaging Quantitative Analysis Used in Benign and Malignant Breast Lesions at 3.0 T

Author: WangSiQi
Tutor: WangDeHang
School: Nanjing Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: Magnatic resonance imaging diffusion weighted imaging Breast neoplasm Magnetic resonance imaging neoadjuvant chemotherapy
CLC: R737.9
Type: Master's thesis
Year: 2011
Downloads: 102
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Abstract


ObjectiveTo evaluate the diagnostic and differential diagnostic value of diffusion weighted imaging quantitative analysis apparent diffusion coefficient used in benign and malignant breast lesions.Methods50 patients with 57 breast lesions examed by clinical ,B-sonography or mammography underwent DWI and DEC-MRI scanning. MRI and DWI manifestations of each lesion were analyzed . Time-intensity curve was obtained by the software of Mean Curve. Measured the ADC values of each lesions by manul. Receiver operating characteristic curve （ROC curve） was used to find the best classification threshold of benign and malignant breast lesions, and then calculating its sensitivity, specificity and accuracy. These were compared to the sensitivity, specificity and accuracy obtained by DCE-MRI conbined with TIC. All the imaging data were compared with pathologic data.ResultsWith b value of 50 and 800 s/mm2, the average ADC value of benign lesions were （1.483±0.358）×10-3mm2/s, while those of malignant ones were （0.952±0.148）×10-3mm2/s. There was a significant difference between the malignant and benign ADC value. The threshold ADC value was 1.219×10-3mm2/s, its diagnosis sensitivity and specificity were 90.6%（29/32）and 84%（21/25）,respectively. The diagnosis sensitivity and specificity obtained by DCE-MRI were 87.5%（28/32）, 80.8%（21/26）. The diagnosis sensitivity and specificity were improved with the combination of DWI and DCE-MRI. There was no significant difference between sensitivity and specificity made by them（P>0.05）.Conclusion1. DWI quantitative analysis ADC value can provide valuable information in diagnosis and differential diagnosis of breast lesions. 2. With its short scanning time , no contrast agents injected , well repeatability and simple post-processing ,DWI will play an important part in breast tumor screening. ObjectiveTo evaluate the value of diffusion weighted imaging quantitative analysis apparent diffusion coefficient used in assessment of early response to neoadjuvant chemotherapy in breast cancer.Methods20 female patients with 22 breast tumors（ all were invasive ductal carcinoma ）,proved by thick needlebiopsy and pathology ) underwent five times of plan MR and DWI scanning at the period of 23 days before neoadjuvant chemotherapy、the mid of the first cycle（911d）,23 days after the first and second cycle and pre-operation（23d）. DWI findings and ADC value of the tumors were assessed and calculated. According to pathological changes,the leisons were divided into two groups- response group and relativly non-response group..All of the 20 patients underwent 34 periods of neoadjuvant chemotherapy.ResultsThe pre-chemotherapy ADC value of the two were （0.767±0.116）×10-3mm2/s and （0.905±0.109）×10-3mm2/s ,respectively. There was statistical difference between them （P<0.05）. After half cycle of chemotherapy , the ADC value of response group and non-response group were increased to （0.966±0.108）×10-3mm2/s and （0.938±0.104）×10-3mm2/s。In response group there were statistical difference between pre-chemotherapy ADC value and ADC value of mid of the first cycle, first cycle, second cycle and pre-opreation （P<0.05）, while no statistical difference in non-response group（P>0.05）, except in pre-opreation ADC value （P<0.05）.The change of ADC value between pre-chemotherapy and mid of the first cycle, first cycle in these two group had statistical difference （P<0.05）. Change of ADC value of mid of the first cycle and first cycle correlated with pre-chemotherapy ADC value（r=-0.559,P<0.05） and （r=-0.485,P<0.05）respectively. Receiver operating characteristic curve （ROC curve） was used to find the best classification threshold .The threshold ADC value of mid of the first cycle cycle change was 0.028×10-3mm2/s.Its sensitivity ,specificity ,positive predictive, negative predictive and accuracy were 85.7%（12/14）,75%（6/8）,85.7%（12/14）,75%（6/8）,81.8%（18/22）.Conclusion3.0 T MR diffusion weighted imaging quantitative analysis ADC value can provide valuable information in assessment of early response to neoadjuvant chemotherapy in breast cancer.

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CLC: > Medicine, health > Oncology > Genitourinary tumors > Breast tumor
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