scholarly journals Breast Lesion Characterisation with Diffusion Weighted Imaging Versus Dynamic Contrast Enhanced-MRI: A Prospective Observational Study in a Tertiary Care Hospital

EMJ Radiology ◽  
2021 ◽  
pp. 75-82
Author(s):  
Amandeep Singh ◽  
Jasmin Purewal ◽  
Kamlesh Gupta ◽  
Gauravdeep Singh
Keyword(s):  
Predictive Value ◽  
Diffusion Weighted Imaging ◽  
Histopathological Diagnosis ◽  
Breast Lesions ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Malignant Lesions ◽  
Lesion Characterisation

Purpose: Dynamic contrast-enhanced (DCE)-MRI has a promising role in breast cancer detection and lesion characterisation. Diffusion-weighted imaging (DWI) acts as an adjunct in the differentiation between benign and malignant lesions. The purpose of the study was to evaluate the efficacy of DCE-MRI and DWI in differentiating benign and malignant lesions. Methods: In a prospective study conducted between March 2019 and February 2020, 60 patients with breast lesions underwent DWI combined with DCE-MRI of the breast. The time–intensity curves were plotted. Lesions were classified according to the latest American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS; 5th edition). The results were compared with the histopathological diagnosis. The sensitivity and specificity of DWI, DCE-MRI, and combined DWI and DCE-MRI were calculated for detection of benign and malignant breast lesions. Results: Sixty patients underwent breast MRI in which 78 lesions were detected, out of which 28 were benign and 50 were malignant. Quantitative apparent diffusion coefficient measurement revealed 96% sensitivity and 82% specificity, with a positive predictive value of 92% and negative predictive value of 96%, for differentiating benign from malignant lesions. DCE-MRI findings showed 96% sensitivity and 78.5% specificity. The sensitivity of combined DWI and DCE-MRI was 98% and specificity was 86%, which was higher than DWI and DCE-MRI alone. Conclusion: Multiparametric MRI of the breast has very high sensitivity for detecting and characterising breast lesions as benign or malignant lesions. DWI had higher specificity than DCE-MRI, and the combined use of DWI and DCE-MRI had greater efficacy than DWI and DCE-MRI alone.

scholarly journals Role of MRI in Differentiating Benign from Malignant Breast Lesions Using Dynamic Contrast Enhanced MRI and Diffusion Weighted MRI

2021 ◽  
Vol 10 (19) ◽  
pp. 1422-1428
Author(s):  
Kunal Singh Ahluwalia ◽  
Harneet Narula ◽  
Amit Jain ◽  
Anshul Arora ◽  
Aditi Vohra ◽  
...  
Keyword(s):  
Breast Lesions ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
Contrast Enhanced Mri

BACKGROUND Breast cancer is the second most common cancer in Indian women. Dynamic contrast enhanced MRI (DCE-MRI) has improved specificity in characterising breast lesions. Diffusion weighted imaging can improve the sensitivity and specificity of MRI in the evaluation of breast lesions thus differentiating between benign and malignant breast lesions. The purpose of the study was to evaluate the role of diffusion weighted MRI and dynamic contrast enhanced MRI in differentiating benign from malignant breast lesions and to compare its findings with histopathological or fine needle aspiration cytology (FNAC) findings. METHODS A descriptive diagnostic study enrolled 30 female patients of palpable breast lumps with positive findings either on mammography or ultrasound. Ultrasonography was done on HD 15 (Philips Medical Systems, USA). This was followed by MRI which was done on MULTIVA 1.5 T using a dedicated breast array coil. RESULTS Fibroadenoma accounted for majority of benign lesions (4 / 10) while invasive ductal carcinoma (IDC) accounted for majority of malignant lesions (15 / 20). 7 / 10 benign lesions showed type I curve, while majority (15 / 20) of the malignant lesions showed type III curve. 8 / 10 benign breast lesions did not show restricted diffusion on diffusion weighted imaging (DWI) while all malignant lesions showed restricted diffusion on DWI. In our study, the mean apparent diffusion coefficient (ADC) value for benign and malignant lesions was 1.59 x 10-3 mm2 / s and 0.88 x 10- 3 mm2 / s respectively. CONCLUSIONS MR morphology, DCE-MRI and DWI are useful to characterise various breast lesions. MRI features of signal intensity of hypointensity on T2WI with other associated features of irregular shape, spiculate margins, heterogeneous enhancement on DCEMRI, type III dynamic curve and reduced ADC value are strong predictors of malignancy. KEY WORDS Breast MRI, DCE-MRI, DWI, Breast Carcinoma

Multiparametric Approach with Dynamic Contrast-Enhanced Mri, Diffusion-Weighted Imaging and Mrs of The Breast in Assessment of Suspicious Breast Lesions

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 16-16
Author(s):  
SM Abd Elsalam ◽  
AH Said ◽  
MH Sarah
Keyword(s):  
Magnetic Resonance ◽  
Diffusion Weighted Imaging ◽  
Kinetic Curve ◽  
Resonance Spectroscopy ◽  
Breast Lesions ◽  
Adc Value ◽  
Dynamic Contrast Enhanced ◽  
Cancer Breast ◽  
Diffusion Weighted ◽  
Contrast Enhanced

Introduction: Breast cancer is the most invasive malignant tumour in females worldwide and is the second leading cause of cancer death in females after lung cancer. In Egypt, cancer breast is the first common site of tumours among females (32%) and the second common tumour site in both sexes. The aim of this study was to evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and magnetic resonance spectroscopy (MRS) with ultrasound +/- conventional mammography in differentiating suspicious breast masses (BI-RADS III and IV) and to suggest the most accurate imaging combination for early diagnosis and treatment of cancer breast. Materials and Methods: The study included 40 patients with suspicious breast lesions detected by clinical examination, ultrasound+/- mammography . Dynamic MRI study was performed using 1.5T MRI. Lesions were analyzed regarding their morphology, kinetic curve pattern, ADC value and tCho peak measurement. The results of each MRI parameter were correlated to histo-pathology. Results: In this study sensitivity of sono-mammography was 70% and its specificity was 66.6%. According to using MRI sensitivity was 90% and specificity was 80% by using morphological and curve patterns. As regarding MRS sensitivity was 50% and specificity was 86.7%. Regarding sensitivity of ADC was 90%while its specificity was 93%. The cut off ADC value was 0.95 x 10−3 mm2/s. By using MRI with additive modalities (ADC and MRS) sensitivity was 100% and specificity was 93%. Conclusion: In comparison with MRI, sonomammography alone lack both sensitivity and specificity in detection of breast lesions in suspicious cases. MRI with additive modalities (ADC and MRS) is the best imaging modality in detection of malignant cases and exclusion of benign cases.

Role of Various DW MRI and DCE MRI Parameters as Predictors of Malignancy in Solid Pulmonary Lesions

2020 ◽  
pp. 084653712091489
Author(s):  
Neeraj Kumar ◽  
Mini Sharma ◽  
Neeti Aggarwal ◽  
Sanjiv Sharma ◽  
Malay Sarkar ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diffusion Weighted Imaging ◽  
Breath Hold ◽  
Data Set ◽  
Predictive Values ◽  
Pulmonary Lesions ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced

Purpose: We aimed to evaluate various diffusion and dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) parameters in differentiating malignant from benign pulmonary lesions. Methods: We enrolled 31 (22 males) patients who had solid pulmonary lesion(s) >2 cm in our cross sectional study. Of these, 23 (74.2%) were found to be malignant on histopathology. Dynamic contrast-enhanced MRI was performed using 36 dynamic measurements (volumetric interpolated breath-hold examination). Diffusion-weighted MRI (DW MRI) performed at b value of 800 s/mm2. We measured different diffusion and perfusion parameters, for example, diffusion-weighted imaging (DWI) SI, mean apparent diffusion coefficient (ADC), minimum ADC, lesion-to-spinal cord ratio, DWI score, T2 score, Ktrans, Kep, and Ve. We stratified values of each parameter as high if it was >median of values observed in our data set and low if it was ≤median. Normally distributed data were compared by unpaired t test, whereas non-normal continuous data were compared by Kruskal Wallis-H test. We applied Wilson score method to calculate sensitivity, specificity, and predictive values of parameters that were statistically significant by type of lesion with reference to histopathological examination as gold standard. Results: Diffusion-weighted imaging SI, mean ADC, minimum ADC, DWI score and Ktrans values were found to be significantly different ( P value < .05) by type of lesion. Ktrans was found to have the highest diagnostic accuracy (74.2%) among these parameters. Conclusion: Ktrans and mean ADC had similar sensitivity of 65.2%. However, Ktrans had highest diagnostic accuracy among various DWI and DCE MRI parameters in predicting malignancy in solid pulmonary lesions. In our study, we found a cutoff value 0.251 min−1 for Ktrans as 100% specific.

Subcategorization of Suspicious Breast Lesions (BI-RADS Category 4) According to MRI Criteria: Role of Dynamic Contrast-Enhanced and Diffusion-Weighted Imaging

2015 ◽  
Vol 205 (1) ◽  
pp. 222-231 ◽  
Author(s):  
João Ricardo Maltez de Almeida ◽  
André Boechat Gomes ◽  
Thomas Pitangueira Barros ◽  
Paulo Eduardo Fahel ◽  
Mário de Seixas Rocha
Keyword(s):  
Diffusion Weighted Imaging ◽  
Breast Lesions ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
And Diffusion

Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of papillary breast lesions

2017 ◽  
Vol 24 (2) ◽  
pp. 176-179 ◽  
Author(s):  
Seyma Yildiz ◽  
Huseyin Toprak ◽  
Yeliz Emine Ersoy ◽  
Fatma Ümit Malya ◽  
Ayşe Ahsen Bakan ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Breast Lesions ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

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.

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