scholarly journals Diffusion-weighted imaging of suspicious (BI-RADS 4) breast lesions: stratification based on histopathology

2017 ◽  
Vol 50 (3) ◽  
pp. 154-161 ◽  
Author(s):  
João Ricardo Maltez de Almeida ◽  
André Boechat Gomes ◽  
Thomas Pitangueira Barros ◽  
Paulo Eduardo Fahel ◽  
Mario de Souza Rocha
Keyword(s):  
High Risk ◽  
Coefficient Of Variation ◽  
Diffusion Weighted Imaging ◽  
Roc Curves ◽  
Sampling Period ◽  
Breast Lesions ◽  
Real Difference ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Mass Lesions

Abstract Objective: To test the use of diffusion-weighted imaging (DWI) in stratifying suspicious breast lesions (BI-RADS 4), correlating them with histopathology. We also investigated the performance of DWI related to the main enhancement patterns (mass and non-mass) and tested its reproducibility. Materials and Methods: Seventy-six patients presented 92 lesions during the sampling period. Two independent examiners reviewed magnetic resonance imaging studies, described the lesions, and determined the apparent diffusion coefficient (ADC) values. Differences among benign, indeterminate- to high-risk, and malignant findings, in terms of the ADCs, were assessed by analysis of variance. Using receiver operating characteristic (ROC) curves, we compared the performance of ADC values in masses and non-mass lesions, and tested the reproducibility of measurements by determining the coefficient of variation and smallest real difference. Results: Among the 92 lesions evaluated, the histopathology showed that 37 were benign, 11 were indeterminate- to high-risk, and 44 were malignant. The mean ADC differed significantly among those histopathological groups, the value obtained for the malignant lesions (1.10 × 10-3 mm2/s) being significantly lower than that obtained for the other groups (p < 0.001). ROC curves demonstrated that DWI performed better when applied to masses than when applied to non-mass lesions (area under the curve, 0.88 vs. 0.67). Reproducibility was good (coefficient of variation, 7.03%; and smallest real difference, ± 0.242 × 10-3 mm2/s). Conclusion: DWI can differentiate between malignant and nonmalignant (benign or indeterminate- to high-risk) lesions, showing better performance for masses. Nevertheless, stratification based on histopathological criteria that are more refined has yet to be achieved.

scholarly journals DIFFUSION-WEIGHTED IMAGING IN MR MAMMOGRAPHY AS AN ALTERNATIVE TO BIOPSY IN THE EVALUATION OF INTERMEDIATE NON-MASS BREAST LESIONS

2019 ◽  
Vol 7 (2) ◽  
pp. 171-179
Author(s):  
Fatma Mohamed Awad
Keyword(s):  
Diffusion Weighted Imaging ◽  
Morphological Characteristics ◽  
Breast Lesions ◽  
Mr Mammography ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Adc Values ◽  
Malignant Lesions ◽  
Mass Lesions

Background: Dynamic contrast-enhanced MRI is a sensitive tool for the diagnosis of breast cancer, however, its value is limited in cases of non-mass enhancement. Diffusion-weighted imaging (DWI) is promising in the diagnosis of non-mass breast lesions. Purpose: The aim of this study is to determine the value of diffusion-weighted imaging in the evaluation of intermediate non-mass breast lesions, as an alternative to biopsy. Materials and Methods: Thirty-three female patients between the ages of 38-56 years (mean age, 45 years) with non-mass lesions on MR mammography were included in this study. The lowest ADC values were obtained for the non-mass breast lesions. MR-guided core-needle biopsies were performed for 20 patients, while the other patients who refused biopsy, had yearly mammography and ultrasound every six months for two years. They also had at least one follow up MR mammography within the two years’ interval. Results: This study included 33 non-mass breast lesions detected on MR mammography. The lesion siz¬es ranged from 0.2 to 1.4 cm. The morphological characteristics of the lesions and their signal intensity curves on dynamic MR Mammography were recorded. For differentiation of benign and malignant lesions, a threshold ADC value of 1.03×10–3   mm2/s was used. The ADC values for all the lesions ranged from 1.3 x 10–3 mm2/s to 2.6 x 10–3   mm2/s. Conclusion: Diffusion-weighted imaging is effective in the evaluation of intermediate non-mass breast lesions on MR mammography and can be used as an alternative to biopsy.

Effects of contrast-enhancement on diffusion weighted imaging and apparent diffusion coefficient measurements in 3-T magnetic resonance imaging of breast lesions

2017 ◽  
Vol 59 (8) ◽  
pp. 902-908
Author(s):  
Valentina Cipolla ◽  
Daniele Guerrieri ◽  
Giacomo Bonito ◽  
Simone Celsa ◽  
Carlo de Felice
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Diffusion Weighted Imaging ◽  
Breast Lesions ◽  
Post Contrast ◽  
Diffusion Weighted ◽  
Signed Rank ◽  
Apparent Diffusion ◽  
Malignant Breast ◽  
Adc Values

Background The effect of gadolinium-based contrast agents on diffusion-weighted imaging (DWI) measurements of breast lesions is still not clear. Purpose To investigate gadolinium effects on DWI and apparent diffusion coefficient (ADC) in breast lesions and normal parenchyma with 3 Tesla contrast-enhanced MRI. Material and Methods Pre- and post-contrast DWI (b = 0 and b = 1000 s/mm2) were acquired in 47 patients. Measured ADC values, pre- and post-contrast T2 signal intensity (T2 SI) and contrast-to-noise ratio (CNR) were compared with Wilcoxon signed-rank and rank-sum test ( P < 0.05). Results Post-contrast ADC was reduced only in malignant lesions (−34%), T2 SI was reduced both in malignant (−50%) and benign (−36%) lesions. Post-contrast CNR was reduced in all groups except for benign lesions. Conclusion Gadolinium-based contrast agent causes a significant reduction in ADC values of malignant breast lesions.

scholarly journals Quantitative Evaluation of apparent diffusion coefficient in a large multi-unit institution using the QIBA diffusion phantom.

2020 ◽  
Author(s):  
Joshua P Yung ◽  
Yao Ding ◽  
Ken-Pin Hwang ◽  
Carlos E Cardenas ◽  
Hua Ai ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Coefficient Of Variation ◽  
Diffusion Weighted Imaging ◽  
Diffusion Weighted ◽  
Apparent Diffusion Coefficient Values ◽  
Wide Range ◽  
Apparent Diffusion ◽  
Adc Values ◽  
The One

Purpose: The purpose of this study was to determine the quantitative variability of diffusion weighted imaging and apparent diffusion coefficient values across a large fleet of MR systems. Using a NIST traceable magnetic resonance imaging diffusion phantom, imaging was reproducible and the measurements were quantitatively compared to known values. Methods: A fleet of 23 clinical MRI scanners was investigated in this study. A NIST/QIBA DWI phantom was imaged with protocols provided with the phantom. The resulting images were analyzed and ADC maps were generated. User-directed region-of-interests on each of the different vials provided ADC measurements among a wide range of known ADC values. Results: Three diffusion phantoms were used in this study and compared to one another. From the one-way analysis of the variance, the mean and standard deviation of the percent errors from each phantom were not significantly different from one another. The low ADC vials showed larger errors and variation and appear directly related to SNR. Across all the MR systems and data, the coefficient of variation was calculated and Bland-Altman analysis was performed. ADC measurements were similar to one another except for the vials with the lower ADC values, which had a higher coefficient of variation. Conclusion: ADC values among the three phantoms showed good agreement and were not significantly different from one another. The large percent errors seen primarily at the low ADC values were shown to be a consequence of the SNR dependence and very little bias was observed between magnetic strengths and manufacturers. ADC values between diffusion phantoms were not statistically significant. Future investigations will be performed to study differences in magnetic field strength, vendor, MR system models, gradients, and bore size. More data across different MR platforms would facilitate quantitative measurements for multi-platform and multi-site imaging studies. With the increasing usage of diffusion weighted imaging in the clinic, the characterization of ADC variability for MR systems provides an improved quality control over the MR systems.

scholarly journals Utility of diffusion weighted mr in diffrentation between benign and malgnant breast lesions

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A E E Rady ◽  
H M Sakr ◽  
Y I Abdelkhalie ◽  
A S M Sadek
Keyword(s):  
Diffusion Weighted Imaging ◽  
Breast Lesions ◽  
Adc Value ◽  
Breast Masses ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Apparent Diffusion ◽  
Malignant Breast ◽  
Adc Values ◽  
Value Measurement

Abstract Purpose of this Study is To evaluate the role of DWI MRI in the differentiation between benign and malignant breast lesions. Methods The study included 40 patients all of them were females with positive breast lesion detected by ultrasound or mammography (between 25 and 66 years of age) referred from surgery and oncology departments. Each patient included in the study was subjected to full history taking, mammography, ultrasonography and conventional MRI sequences and Diffusion Weighted imaging and ADC value measurement. Technique was performed using a standard 1.5 Tesla unit (Acheiva, Philips). Results The study showed significant results were obtained between ADC values of benign and malignant lesions (p &lt; 0.001). Conclusion According to the results of this study we concluded that the addition of DW-MRI and ADC value measurements to the conventional MRI of the breast increased the accuracy of diagnosis and characterization of different breast masses. Also, the use of DW-MRI with ADC value measurements was found to be a valuable quantitative analysis. Keywords Breast masses– MRI – Diffusion weighted imaging Apparent diffusion coefficient.

scholarly journals Differentiation of Breast Lesions and Distinguishing Their Histological Subtypes Using Diffusion-Weighted Imaging and ADC Values

2020 ◽  
Vol 10 ◽  
Author(s):  
Jelena Maric ◽  
Jasmina Boban ◽  
Tatjana Ivkovic-Kapicl ◽  
Dragana Djilas ◽  
Viktorija Vucaj-Cirilovic ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Breast Lesions ◽  
Histological Subtypes ◽  
Diffusion Weighted ◽  
Adc Values

scholarly journals Integrated slice-specific dynamic shimming diffusion weighted imaging (DWI) for rectal Cancer detection and characterization

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianxing Qiu ◽  
Jing Liu ◽  
Zhongxu Bi ◽  
Xiaowei Sun ◽  
Xin Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Image Quality ◽  
Diffusion Weighted Imaging ◽  
Rectal Tumor ◽  
B Values ◽  
Primary Rectal Cancer ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Group 2 ◽  
Group 1

Abstract Purpose To compare integrated slice-specific dynamic shimming (iShim) diffusion weighted imaging (DWI) and single-shot echo-planar imaging (SS-EPI) DWI in image quality and pathological characterization of rectal cancer. Materials and methods A total of 193 consecutive rectal tumor patients were enrolled for retrospective analysis. Among them, 101 patients underwent iShim-DWI (b = 0, 800, and 1600 s/mm2) and 92 patients underwent SS-EPI-DWI (b = 0, and 1000 s/mm2). Qualitative analyses of both DWI techniques was performed by two independent readers; including adequate fat suppression, the presence of artifacts and image quality. Quantitative analysis was performed by calculating standard deviation (SD) of the gluteus maximus, signal intensity (SI) of lesion and residual normal rectal wall, apparent diffusion coefficient (ADC) values (generated by b values of 0, 800 and 1600 s/mm2 for iShim-DWI, and by b values of 0 and 1000 s/mm2 for SS-EPI-DWI) and image quality parameters, such as signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of primary rectal tumor. For the primary rectal cancer, two pathological groups were divided according to pathological results: Group 1 (well-differentiated) and Group 2 (poorly differentiated). Statistical analyses were performed with p < 0.05 as significant difference. Results Compared with SS-EPI-DWI, significantly higher scores of image quality were obtained in iShim-DWI cases (P < 0.001). The SDbackground was significantly reduced on b = 1600 s/mm2 images and ADC maps of iShim-DWI. Both SNR and CNR of b = 800 s/mm2 and b = 1600 s/mm2 images in iShim-DWI were higher than those of b = 1000 s/mm2 images in SS-EPI-DWI. In primary rectal cancer of iShim-DWI cohort, SIlesion was significantly higher than SIrectum in both b = 800 and 1600 s/mm2 images. ADC values were significantly lower in Group 2 (0.732 ± 0.08) × 10− 3 mm2/s) than those in Group 1 ((0.912 ± 0.21) × 10− 3 mm2/s). ROC analyses showed significance of ADC values and SIlesion between the two groups. Conclusion iShim-DWI with b values of 0, 800 and 1600 s/mm2 is a promising technique of high image quality in rectal tumor imaging, and has potential ability to differentiate rectal cancer from normal wall and predicting pathological characterization.

scholarly journals Role of Quantitative Diffusion-Weighted Imaging in Differentiating Benign and Malignant Orbital Masses

2021 ◽  
Author(s):  
Preeti Mundhada ◽  
Sudarshan Rawat ◽  
Ullas Acharya ◽  
Dhananjay Raje
Keyword(s):  
Roc Curve ◽  
Diffusion Weighted Imaging ◽  
Care Hospital ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Orbital Masses ◽  
Adc Values ◽  
Orbital Lesions

Abstract Aim To determine the role of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) values in differentiating benign and malignant orbital masses. Materials and Methods After obtaining institutional ethical board approval and informed consent from all patients, an observational study was done for a period of 24 months in the radiology department of a tertiary care hospital in South India. Conventional magnetic resonance imaging and DWI using a 3T scanner was done for all patients with suspected orbital mass lesion. ADC value and clinicohistopathological correlation were studied for every patient. Chi-square test was used to compare the signal characteristics of DWI and ADC maps between benign and malignant lesions. A comparison of mean ADC values for benign and malignant masses was performed using Student’s t-test for independent samples. The cut-off value for ADC was obtained using the receiver operating characteristic (ROC) curve. Results Of 44 patients with orbital lesions, 70% were benign and 30% were malignant. There was a significant difference in the mean ADC values of benign and malignant orbital masses. Using ROC curve analysis, an optimal ADC threshold of 1.26 × 10−3 mm2/s was calculated for the prediction of malignancy with 100% sensitivity, 80.65% specificity, and 86.36% accuracy (95% confidence interval: 0.872, 1.00, p < 0.0001). Two ADC thresholds were used to characterize the orbital masses with more than 90% confidence. Conclusion Quantitative assessment of ADC is a useful noninvasive diagnostic tool for differentiating benign and malignant orbital masses. Malignant orbital lesions demonstrate significantly lower ADC values as compared with benign lesions.

scholarly journals Diffusion tensor imaging on 3-T MRI breast: diagnostic performance in comparison to diffusion-weighted imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dalia Abdelhady ◽  
Amany Abdelbary ◽  
Ahmed H. Afifi ◽  
Alaa-eldin Abdelhamid ◽  
Hebatallah H. M. Hassan
Keyword(s):  
Breast Cancer ◽  
Diffusion Tensor Imaging ◽  
Sensitivity And Specificity ◽  
Diffusion Weighted Imaging ◽  
Diffusion Tensor ◽  
Breast Mri ◽  
Breast Lesions ◽  
Dce Mri ◽  
Additional Tool ◽  
Diffusion Weighted

Abstract Background Breast cancer is the most prevalent cancer among females. Dynamic contrast-enhanced MRI (DCE-MRI) breast is highly sensitive (90%) in the detection of breast cancer. Despite its high sensitivity in detecting breast cancer, its specificity (72%) is moderate. Owing to 3-T breast MRI which has the advantage of a higher signal to noise ratio and shorter scanning time rather than the 1.5-T MRI, the adding of new techniques as diffusion tensor imaging (DTI) to breast MRI became more feasible. Diffusion-weighted imaging (DWI) which tracks the diffusion of the tissue water molecule as well as providing data about the integrity of the cell membrane has been used as a valuable additional tool of DCE-MRI to increase its specificity. Based on DWI, more details about the microstructure could be detected using diffusion tensor imaging. The DTI applies diffusion in many directions so apparent diffusion coefficient (ADC) will vary according to the measured direction raising its sensitivity to microstructure elements and cellular density. This study aimed to investigate the diagnostic accuracy of DTI in the assessment of breast lesions in comparison to DWI. Results By analyzing the data of the 50 cases (31 malignant cases and 19 benign cases), the sensitivity and specificity of DWI in differentiation between benign and malignant lesions were about 90% and 63% respectively with PPV 90% and NPV 62%, while the DTI showed lower sensitivity and specificity about 81% and 51.7%, respectively, with PPV 78.9% and NPV 54.8% (P-value ≤ 0.05). Conclusion While the DWI is still the most established diffusion parameter, DTI may be helpful in the further characterization of tumor microstructure and differentiation between benign and malignant breast lesions.

scholarly journals Comparison between turbo spin-echo and echo planar diffusion-weighted imaging of the female pelvis with 3T MRI

2021 ◽  
Vol 10 (2) ◽  
pp. 205846012199473
Author(s):  
Takeshi Yoshizako ◽  
Rika Yoshida ◽  
Hiroya Asou ◽  
Megumi Nakamura ◽  
Hajime Kitagaki
Keyword(s):  
Image Quality ◽  
Diffusion Weighted Imaging ◽  
Spin Echo ◽  
Turbo Spin Echo ◽  
Female Pelvis ◽  
3T Mri ◽  
Turbo Spin ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Echo Planar

Background Echo-planar imaging (EPI)-diffusion-weighted imaging (DWI) may take unclear image affected by susceptibility, geometric distortions and chemical shift artifacts. Purpose To compare the image quality and usefulness of EPI-DWI and turbo spin echo (TSE)-DWI in female patients who required imaging of the pelvis. Material and Methods All 57 patients were examined with a 3.0-T MR scanner. Both TSE- and EPI-DWI were performed with b values of 0 and 1000 s/mm2. We compared geometric distortion, the contrast ratio (CR) of the myometrium to the muscle and the apparent diffusion coefficient (ADC) values for the myometrium and lesion. Two radiologists scored the TSE- and EPI-DWI of each patient for qualitative evaluation. Results The mean percent distortion was significantly smaller with TSE- than EPI-DWI ( p = 0.00). The CR was significantly higher with TSE- than EPI-DWI ( p = 0.003). There was a significant difference in the ADC value for the uterus and lesions between the EPI- and TSE-DWI ( p < 0.05). Finally, the ADC values of cancer were significantly different from those for the uterus and benign with both the two sequences ( p < 0.05). The scores for ghosting artifacts were higher with TSE- than EPI-DWI ( p = 0.019). But there were no significant differences between TSE- and EPI-DWI with regard to image contrast and overall image quality. Conclusion TSE-DWI on the female pelvis by 3T MRI produces less distortion and higher CR than EPI-DWI, but there is no difference in contrast and image quality.

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