The aim of this study was to correlate the apparent diffusion coefficient (ADC) value of invasive ductal carcinoma with pathological prognostic factors. A prospective study was conducted on 59 untreated female patients (mean age 46 years) with invasive ductal carcinoma. All patients were examined at 1.5 Tesla using dedicated bilateral breast coil. They underwent diffusion weighted MR imaging of the breast using a single shot echo planar imaging with a b-factor of 200 and 400 sec/mm2. Apparent diffusion coefficient (ADC) maps were reconstructed. The ADC value of the breast cancer was calculated and correlated with the pathologic prognostic factors (tumor size, grade and lymph nodes). The mean ADC values of invasive ductal carcinoma were significantly lower in patients with high grade, large breast cancer as well as those with axillary lymph nodes metastasis in a statistically significant way (p = 0.001 for the three factors). The mean ADC value of invasive ductal carcinoma was correlated with histologic grade (r = -0.675, p = 0.001), tumor size (r = 0.504, p = 0.001) and showed lower ADC values with positive lymph node metastasis. Apparent diffusion coefficient value is correlated with pathological parameters of invasive ductal carcinoma. The lower ADC values are associated with higher histological grade, larger tumor size and presence of axillary lymph nodes. So, the ADC value can be considered as a promising prognostic parameter that may identify highly aggressive breast cancer.
Combined ASL and DTI metrics of enhanced lesion and related edema are valuable noninvasive tools in differentiating residual/recurrent gliomas from postradiation changes.
We aimed to assess the clinical usefulness of the ADCs calculated from diffusion-weighted echo-planar MR images in the characterization of pediatric head and neck masses. This study included 78 pediatric patients (46 boys and 32 girls aged 3 months-15 years, mean 6 years) with head and neck mass. Routine MR imaging and diffusion-weighted MR imaging were done on a 1.5-T MR unit using a single-shot echo-planar imaging (EPI) with a b factor of 0.500 and 1,000 s mm(-2). The ADC value was calculated. The mean ADC values of the malignant tumours, benign solid masses and cystic lesions were (0.93 +/- 0.18) x 10(-3), (1.57 +/- 0.26) x 10(-3) and (2.01 +/- 0.21 ) x 10(-3) mm(2) s(-1), respectively. The difference in ADC value between the malignant tumours and benign lesions was statistically significant (p < 0.001). When an apparent diffusion coefficient value of 1.25 x 10(-3) mm(2) s(-1) was used as a threshold value for differentiating malignant from benign head and neck mass, the best results were obtained with an accuracy of 92.8%, sensitivity of 94.4%, specificity of 91.2%, positive predictive value of 91% and negative predictive value of 94.2%. Diffusion-weighted MR imaging is a new promising imaging approach that can be used for characterization of pediatric head and neck mass.
Perfusion MR imaging is a noninvasive promising method that can be used for differentiation of malignant from benign cervical lymph nodes, and it helps in the characterization of malignant cervical lymphadenopathy.
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