scholarly journals Role of multi-parametric MRI in the differentiation between mucinous breast carcinoma and fibroadenoma

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dalia Bayoumi ◽  
Amal Sakrana ◽  
Ebrahim Abdelhalim ◽  
Eman Alnaghy
Keyword(s):  
Breast Carcinoma ◽  
Mr Spectroscopy ◽  
Mucinous Carcinoma ◽  
Older Age ◽  
Irregular Shape ◽  
Adc Value ◽  
Dce Mri ◽  
Rim Enhancement ◽  
The Mean ◽  
Mucinous Breast Carcinoma

Abstract Background The purpose of this study was to evaluate diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and functional MRI (diffusion and MR spectroscopy) using the latest MRI breast imaging reporting and data system (MRI-BIRADS) descriptors and non-BIRADS items for differentiation of mucinous breast carcinomas from fibroadenomas. Methods We included 19 cases of mucinous breast carcinoma and 37 cases of fibroadenoma. DCE-MRI, Diffusion-weighted MR imaging (DWI) and multi-voxel MR spectroscopy (MRS) were done, MRI-BIRADS (5th edition) analysis of the lesions was performed, and histopathological examination of all cases was done. Results According to univariate analysis, mucinous carcinoma was frequently detected in older age-group (COR = 1.4, 95% CI = 1.1–1.7 and p value < 0.001) and had more frequent irregular borders and non-circumscribed margins than fibroadenoma (COR = 11.6, 95% CI = 2–66.4 and p value  = 0.002). All mucinous carcinoma had high T2 signal. Fibroadenomas had more frequent homogenous enhancement than mucinous carcinoma; none of the fibroadenomas had rim enhancement nor enhancing internal septations; mucinous carcinoma had more frequent rim enhancement and (n = 6, p value  < 0.001) and enhancing internal septations (n = 7, p value  < 0.001). Fibroadenoma had frequent dark non-enhancing internal septations than mucinous carcinoma (p value  < 0.001). On multivariate analysis, mucinous carcinoma had significant combination of being common in older age, larger in size, with irregular shape, and non-circumscribed margins. On ADC map and MRS, mucinous carcinoma had higher ADC values and higher CHO.SNR than fibroadenoma. The mean ADC value of mucinous carcinoma was 1.3 ± 0.1 × 10−3mm2/s, which was significantly higher than that of fibroadenoma (1.1 ± 0.1 × 10−3mm2/s), with p = 0.002. Also, the mean CHO.SNR was significantly higher in mucinous carcinoma (3.1 ± 0.8) than fibroadenoma (0.8 ± 0.5) with p value  < 0.001. According to our results, the presence of type 3 (washout curve), dark internal septations, non-circumscribed margins and irregular shape of the lesion showed the highest sensitivity and accuracy for differentiation of mucinous carcinomas and fibroadenomas (100, 78.6%), (89.4, 82%), (86.5, 80.3%) and (81, 71.4%), respectively. Conclusion The combined use of DCE-MRI, DW-MRI and MRS with breast MRI-BIRADS descriptors and non-BIRADS items increases the diagnostic accuracy for differentiation of mucinous carcinomas from fibroadenomas.

Isolated mucinous adrenal metastasis in a breast cancer patient

2011 ◽  
Vol 17 (4) ◽  
pp. 444-447 ◽  
Author(s):  
Umut Demirci ◽  
Suleyman Buyukberber ◽  
Tansel Cakir ◽  
Aylar Poyraz ◽  
Meltem Baykara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Patient ◽  
Breast Cancer Patient ◽  
Hormone Therapy ◽  
Advanced Disease ◽  
Mucinous Carcinoma ◽  
Adrenal Metastasis ◽  
Histological Type ◽  
Mucinous Breast Carcinoma

Mucinous breast carcinoma (MBC) is a rare histological type of breast cancer and rarely associated with advanced disease. We report a case that had MBC with an isolated adrenal metastasis which was removed by laparoscopic adrenelectomy. This case is unique due to the unexpected metastasis of pure mucinous carcinoma developed after 4 years of hormone therapy.

MR spectroscopy compared with DW-MRI and DCE-MRI at 3-tesla for the noninvasive prediction of short-term radiation response for patients with localized prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 122-122
Author(s):  
Gilles Crehange ◽  
Philippe Maingon ◽  
Mélanie Gauthier ◽  
Alexandre Cochet ◽  
Etienne Martin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Mr Spectroscopy ◽  
3 Tesla ◽  
Radiation Response ◽  
Localized Prostate Cancer ◽  
High Dose ◽  
Adc Value ◽  
Dce Mri

122 Background: PSA is not appropriate for assessing early radiation response for patients treated with and without hormones for prostate cancer. New biomarkers using multiparametric functional MR could be of value. To investigate the benefits of multiparametric functional MR for predicting radiation response during the first year after radiation therapy in prostate cancer patients. Methods: Between 01/2008 and 04/2010, 34 patients with a localized prostate cancer (T1-T3, N0) were prospectively enrolled in the ERIS trial. All patients underwent high dose IMRT with or without long term adjuvant hormonal therapy and were prospectively followed with MR spectroscopy, diffusion-weighted MRI and dynamic contrast-enhanced MRI at 3-Tesla without endorectal coil every 3 months up to 1 year. Patients were followed with DRE, PSA level every 3 months and with sextant-biopsy at 6 and 12 months following radiation. Choline and Citrate levels on MRS, apparent diffusion coefficient on DW-MRI and the slope of the contrast uptake on DCE-MRI were measured in the central gland and in the peripheral zone every 3 months over 12 months and compared with PSA nadir at 12 months (≤0.5 ng/mL vs. >0.5 ng/mL). Results: Cho, Cit and SCU significantly decreased over time whereas ADC remained stable. For the entire prostate at 3 months, the mean Cho level was higher in patients with PSA level >0.5 ng/mL at 1 year (10.1±3.0 vs. 6.6±2.5, p= 0.004). Similarly, Cit level was higher at 3 months for patients with PSA level > 0.5 ng/mL at 1 year (15.4±7.9 vs. 8.5±9.9, p= 0.0065). Neither ADC value nor contrast enhancement evaluated at each time interval was correlated with PSA at 1 year. Conclusions: Low Cho and Cit levels evaluated at 3 months are new markers for early success in prostate cancer patients treated with exclusive radiation therapy.

scholarly journals Periodic acid-Schiff and alcian blue immunohistochemistry to detect mucin in mucinous breast carcinoma

2020 ◽  
Vol 29 (1) ◽  
pp. 53-7 ◽  
Author(s):  
Primariadewi Rustamadji ◽  
Jason Wibowo ◽  
Belinda Murtani ◽  
Christy Magdalena
Keyword(s):  
Breast Carcinoma ◽  
Alcian Blue ◽  
Staining Method ◽  
Periodic Acid ◽  
Mucinous Carcinoma ◽  
Blue Staining ◽  
Alcian Blue Staining ◽  
Periodic Acid Schiff ◽  
Pas Staining ◽  
Mucinous Breast Carcinoma

BACKGROUND Detection of mucins has been shown to correlate with several clinicopathological characteristics in patients. Currently, periodic acid-Schiff (PAS) and alcian blue staining methods are the histochemistry staining techniques that are frequently used to detect mucin. This study was aimed to evaluate PAS and alcian blue staining in differentiating mucin characteristics between invasive carcinoma of no special type (ICNST) with mucinous degeneration and mucinous carcinoma. METHODS This cross-sectional study of 33 cases included biopsies of mucinous breast carcinoma and ICNST with mucin degeneration that were histologically verified using hematoxylin and eosin (H&E) staining. The PAS and alcian blue staining were conducted in the Laboratory of Histochemistry, Department of Anatomical Pathology, Cipto Mangunkusumo Hospital. Data were recorded using SPSS software, version 21 (IBM Corp, USA). RESULTS There were 17 cases of ICNST with mucinous degeneration and 16 cases of mucinous carcinoma with age varied from 27 to 75 years. PAS had sensitivity of 87.5% and specificity of 41.2%. Alcian blue had sensitivity of 43.8% and specificity of 82.4%. CONCLUSIONS PAS staining method is better than the alcian blue staining method in distinguishing between ICNST with mucinous degeneration and mucinous carcinoma. In the limited setting laboratory, PAS staining alone can be considered to detect mucin.

scholarly journals Diffusion-weighted imaging or MR spectroscopy: Which to use for the assessment of the response to chemotherapy in breast cancer patients?

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Sahar Mansour ◽  
Ashraf Selim ◽  
Loay Kassam ◽  
Mirna Adel ◽  
Aya Bassam Hashem
Keyword(s):  
Breast Cancer ◽  
Complete Remission ◽  
Cancer Patients ◽  
Mr Spectroscopy ◽  
Residual Disease ◽  
Breast Cancer Patients ◽  
Adc Value ◽  
Dce Mri ◽  
Pathological Complete Remission ◽  
Choline Peak

Abstract Background Diffusion-weighted MRI (DWI) and MR spectroscopy (MRS) both are noninvasive MR sequences that could be used as a reliable tool to assess the functional behavior of the breast cancer. The aim of the study was to assess the value of DWI and MRS in predicting the early response to neo-adjuvant chemotherapy (NAC) and absence of residual disease after treatment. Results One hundred thirty-three patients diagnosed with breast cancer and scheduled for NAC were enrolled in this study. All lesions were subjected to qualitative and quantitative analysis of DCE-MRI, DWI and MRS, where the lesions size, kinetic parameters, ADC values and MRS choline peak were recorded before the start of NAC and after completion of chemotherapy. The results of each MRI modality were correlated with the findings that were found at the pathology report of the complete surgical specimen. The sensitivity and specificity of the MR modalities to predict pathological complete remission post-NAC were 73.68% and 83.33%, respectively, using the kinetic curve pattern, 78.95% and 83.33%, respectively, using the ADC value and finally 78.95% and 91.67%, respectively, using the MRS choline peak. Similar sensitivity (89.47%) to predict pathological complete remission was presented by the ADC value and the MRS choline peak together when compared to the ADC value and dynamic curve patterns. Conclusion DWI and MRS are valuable MRI techniques and their accuracy in detecting residual disease is almost similar to that of DCE MRI. The inclusion of these sequences in the imaging protocol of NAC candidates improve monitoring of the response to treatment and allow early distinction between complete, partial and non-responders' cases in breast cancer patients.

scholarly journals Blood Oxygenation Level Dependent Magnetic Resonance Imaging (MRI), Dynamic Contrast Enhanced MRI and Diffusion Weighted MRI for Benign and Malignant Breast Cancer Discrimination: A Preliminary Experience

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2421
Author(s):  
Roberta Fusco ◽  
Vincenza Granata ◽  
Mauro Mattace Raso ◽  
Paolo Vallone ◽  
Alessandro Pasquale De Rosa ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Univariate Analysis ◽  
Mean Value ◽  
Blood Oxygenation ◽  
Breast Lesions ◽  
Dce Mri ◽  
Malignant Lesions ◽  
The Mean ◽  
And Diffusion ◽  
Skewness And Kurtosis

Purpose. To combine blood oxygenation level dependent magnetic resonance imaging (BOLD-MRI), dynamic contrast enhanced MRI (DCE-MRI), and diffusion weighted MRI (DW-MRI) in differentiation of benign and malignant breast lesions. Methods. Thirty-seven breast lesions (11 benign and 21 malignant lesions) pathologically proven were included in this retrospective preliminary study. Pharmaco-kinetic parameters including Ktrans, kep, ve, and vp were extracted by DCE-MRI; BOLD parameters were estimated by basal signal S0 and the relaxation rate R2*; and diffusion and perfusion parameters were derived by DW-MRI (pseudo-diffusion coefficient (Dp), perfusion fraction (fp), and tissue diffusivity (Dt)). The correlation coefficient, Wilcoxon-Mann-Whitney U-test, and receiver operating characteristic (ROC) analysis were calculated and area under the ROC curve (AUC) was obtained. Moreover, pattern recognition approaches (linear discrimination analysis and decision tree) with balancing technique and leave one out cross validation approach were considered. Results. R2* and D had a significant negative correlation (−0.57). The mean value, standard deviation, Skewness and Kurtosis values of R2* did not show a statistical significance between benign and malignant lesions (p > 0.05) confirmed by the ‘poor’ diagnostic value of ROC analysis. For DW-MRI derived parameters, the univariate analysis, standard deviation of D, Skewness and Kurtosis values of D* had a significant result to discriminate benign and malignant lesions and the best result at the univariate analysis in the discrimination of benign and malignant lesions was obtained by the Skewness of D* with an AUC of 82.9% (p-value = 0.02). Significant results for the mean value of Ktrans, mean value, standard deviation value and Skewness of kep, mean value, Skewness and Kurtosis of ve were obtained and the best AUC among DCE-MRI extracted parameters was reached by the mean value of kep and was equal to 80.0%. The best diagnostic performance in the discrimination of benign and malignant lesions was obtained at the multivariate analysis considering the DCE-MRI parameters alone with an AUC = 0.91 when the balancing technique was considered. Conclusions. Our results suggest that the combined use of DCE-MRI, DW-MRI and/or BOLD-MRI does not provide a dramatic improvement compared to the use of DCE-MRI features alone, in the classification of breast lesions. However, an interesting result was the negative correlation between R2* and D.

scholarly journals Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ali Elsorougy ◽  
Hashim Farg ◽  
Dalia Bayoumi ◽  
Mohamed Abou El-Ghar ◽  
Magda Shady
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Multiparametric Mri ◽  
Histopathological Analysis ◽  
Adc Value ◽  
Intensity Index ◽  
Apparent Diffusion ◽  
The Mean

Abstract Background MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma. Results There were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001). Conclusion Our study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.

scholarly journals Multiple b values of diffusion-weighted magnetic resonance imaging in evaluation of solid head and neck masses

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Rania Sobhy Abou khadrah ◽  
Haytham Haroon Imam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Head And Neck ◽  
Resonance Imaging ◽  
Adc Value ◽  
Neck Masses ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging ◽  
The Mean ◽  
Head And Neck Masses

Abstract Background Differentiation between malignant and benign masses is essential for treatment planning and helps in improving the prognosis of malignant tumors; the aim of this work is to determine the role of diffusion-weighted magnetic resonance imaging (DW-MRI) and the apparent diffusion coefficient (ADC) in the differentiation between benign and malignant solid head and neck masses by comparing diagnostic performance of low b values (0.50 and 400 s/mm2) versus high b values (800 and 1000 s/mm2) and comparing the result with histopathological finding. Results The study included 60 patients (34 male and 26 female) with solid head and neck masses > 1 cm who referred to radiodiagnosis department for MRI evaluation. Multiple b values were used 50, 400, 800, and 1000 s/mm2 (at least 2 b values). DWI and ADC value of all 60 patients were acquired. Mean ADC values of both malignant and benign masses were statistically measured and compared, and cut off value was determined. Solid head and neck masses in our study DWI with the use of high b value 800 and 1000 s/mm2 were of higher significance (P value 0.001*). There was a significant difference in the mean ADC value between benign and malignant masses (P < 0.01); solid masses were divided into 2 categories: (a) malignant lesions 46.7% (n = 28) with mean ADC value (0.82 ± 0.19) × 10−3 s/mm2 and (b) benign lesions 53.3% (n = 32) with mean ADC value (2.05 ± 0.46) × 10−3 s/mm2) with ADC cutoff value of 1.0 × 10−3 s/mm2 and 94% sensitivity, 93% specificity, negative predictive value (NPV) = 94%, positive predictive value (PPV) 93%, and an accuracy of 93.5%. Conclusion The DWI with ADC mapping were valuable as non-invasive tools in differentiating between benign and malignant solid head and neck masses. The use of high b value 800 and 1000 s/mm2 was of higher significance (P value 0.001*) in differentiation between benign and malignant lesion than that with low b values 0, 50, and 400 s/mm2 (0.01). The mean ADC values were significantly lower in malignant solid masses. Attention had to be paid to the choice of b values in MRI-DWI in the head and neck region.

scholarly journals Can mean ADC value and ADC ratio of benign prostate tissue to prostate cancer assist in the prediction of clinically significant prostate cancer within the PI-RADSv2 scoring system?

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Samar Ramzy Ragheb ◽  
Reem Hassan Bassiouny
Keyword(s):  
Prostate Cancer ◽  
Sensitivity And Specificity ◽  
Gleason Score ◽  
Treatment Strategies ◽  
Serum Levels ◽  
Prostatic Tissue ◽  
Histopathological Analysis ◽  
Adc Value ◽  
The Mean ◽  
Clinically Significant

Abstract Background The aim of this study is to investigate whether quantitative DW metrics can provide additive value to the reliable categorization of lesions within existing PI-RADSv2 guidelines. Fifty-eight patients with clinically suspicious prostate cancer who underwent PR examination, PSA serum levels, sextant TRUS-guided biopsies, and bi-parametric MR imaging were included in the study. Results Sixty-six lesions were detected by histopathological analysis of surgical specimens. The mean ADC values were significantly lower in tumor than non-tumor tissue. The mean ADC value inversely correlated with Gleason score of tumors with a significant p value < 0.001.Conversely, a positive relationship was found between the ADC ratio (ADC of benign prostatic tissue to prostate cancer) and the pathologic Gleason score with a significant elevation of the ADC ratio along with an increase of the pathologic Gleason score (p < 0.001). ROC curves constructed for the tumor ADC and ADC ratio helped to distinguish pathologically aggressive (Gleason score ≥ 7) from non-aggressive (Gleason score ≤ 6) tumors and to correlate it with PIRADSv2 scoring to predict the presence of clinically significant PCA (PIRADSv2 DW ≥ 4). The ability of the tumor ADC and ADC ratio to predict highly aggressive tumors (GS> 7) was high (AUC for ADC and ADC ratio, 0.946 and 0.897; p = 0.014 and 0.039, respectively). The ADC cut-off value for GS ≥ 7 was < 0.7725 and for GS ≤ 6 was > 0.8620 with sensitivity and specificity 97 and 94%. The cutoff ADC ratio for predicting (GS > 7) was 1.42 and for GS ≤ 6 was > 1.320 with sensitivity and specificity 97 and 92%. By applying this ADC ratio cut-off value the sensitivity and specificity of reader 1 for correct categorization of PIRADSv2 DW > 4 increased from 90 and 68% to 95 and 90% and that of reader 2 increased from 94 and 88% to 97 and 92%, respectively. Conclusion Estimation of DW metrics (ADC and ADC ratio between benign prostatic tissue and prostate cancer) allow the non-invasive assessment of biological aggressiveness of prostate cancer and allow reliable application of the PIRADSv2 scoring to determine clinically significant cancer (DW score > 4) which may contribute in planning initial treatment strategies.

scholarly journals The value of the added diffusion-weighted images to multiparametric MRI in the early diagnosis of uterine cervix cancers and nodal assessment

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Nasr Mohamed Osman ◽  
Mohamed Aboul-fotouh Mourad
Keyword(s):  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Multiparametric Mri ◽  
Lesion Group ◽  
Cervical Lesions ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Group I ◽  
Malignant Lesions ◽  
The Mean

Abstract Background Cervical cancer still one of the most common causes of tumor-related death in developing countries presented in younger women. In this study, we aimed to evaluate the value of diffusion-weighted MRI in early diagnosis of malignant cervical lesions, to assess metastatic adenopathy, peritoneal dissemination, and possible tumor recurrence, and determine treatment response. This study included 60 patients with abnormal vaginal bleeding and suspected cervical lesion by US. A histopathological biopsy was done. Pelvic MR with DWI and dynamic contrast-enhanced MRI were done for all patients. Results According to the histopathological findings, we divided our studied 60 patents into two groups: group I, malignant lesions (46 lesions; 76.7%), and group II, benign lesions (14 lesions; 23.3%). Multiparametric MRI could detect all cervical lesions but with poor pathologic characterization, achieving 72.37% sensitivity, 37.50% specificity, 63.33% accuracy, 76.19% PPV, and 33.33% NPV. When compared with DWI with ADC value measurements at high b value (b = 800) to MRI exam, it showed a higher diagnostic accuracy with good lesion pathological characterization that achieved 95.65% sensitivity, 71.43% specificity, 90% accuracy, 91.67 PPV, and 83.33% NPV. The mean ADC value for malignant lesions was 0.86–1.1, mean = 0.92 ± 0.71 × 10−3 mm2/s, while the mean ADC value in the benign lesion group was 1.18 ± 0.1 × 10–3 mm2/s. Conclusion Comparing DWI with ADC values measurements at high b value to the multiparametric MRI examination of the female pelvis increases the sensitivity, specificity, and diagnostic accuracy of characterization and early diagnosis of cervical malignant focal lesions and reduces the need for intravenous contrast administration.

scholarly journals Role of diffusion-weighted magnetic resonance imaging in assessment of mammographically detected asymmetric densities

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Zidan ◽  
Shimaa Ali Saad ◽  
Eman Abo Elhamd ◽  
Hosam Eldin Galal ◽  
Reem Elkady
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Benign Lesions ◽  
Adc Value ◽  
Dce Mri ◽  
Diffusion Weighted ◽  
Breast Asymmetries ◽  
Malignant Lesions

Abstract Background Asymmetric breast density is a potentially perplexing finding; it may be due to normal hormonal variation of the parenchymal pattern and summation artifact or it may indicate an underlying true pathology. The current study aimed to identify the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) values in the assessment of breast asymmetries. Results Fifty breast lesions were detected corresponding to the mammographic asymmetry. There were 35 (70%) benign lesions and 15 (30%) malignant lesions. The mean ADC value was 1.59 ± 0.4 × 10–3 mm2/s for benign lesions and 0.82 ± 0.3 × 10–3 mm2/s for malignant lesions. The ADC cutoff value to differentiate between benign and malignant lesions was 1.10 × 10–3 mm2/s with sensitivity 80%, specificity 88.6%, positive predictive value 75%, negative predictive value 91%, and accuracy 86%. Best results were achieved by implementation of the combined DCE-MRI and DWI protocol, with sensitivity 93.3%, specificity 94.3%, positive predictive value 87.5%, negative predictive value 97.1%, and accuracy 94%. Conclusion Dynamic contrast-enhanced MRI (DCE-MRI) was the most sensitive method for the detection of the underlying malignant pathology of breast asymmetries. However, it provided a limited specificity that may cause improper final BIRADS classification and may increase the unnecessary invasive procedures. DWI was used as an adjunctive method to DCE-MRI that maintained high sensitivity and increased specificity and the overall diagnostic accuracy of breast MRI examination. Best results can be achieved by the combined protocol of DCE-MRI and DWI.

Sign in / Sign up

Export Citation Format

Share Document