Purpose:To evaluate the role of diffusion-weighted imaging (DWI) in the detection of breast cancers, and to correlate the apparent diffusion coefficient (ADC) value with prognostic factors. Materials and Methods:Sixty-seven women with invasive cancer underwent breast MRI. Histological specimens were analyzed for tumor size and grade, and expression of estrogen receptors (ER), progesterone receptors, c-erbB-2, p53, Ki-67, and epidermal growth factor receptors. The computed mean ADC values of breast cancer and normal breast parenchyma were compared. Relationships between the ADC values and prognostic factors were determined using Wilcoxon signed rank test and Kruskal-Wallis test.Results: DWI detected breast cancer as a hyperintense area in 62 patients (92.5 %). A statistically significant difference in the mean ADC values of breast cancer (1.09 Ϯ 0.27 ϫ 10 Ϫ5 mm 2 /s) and normal parenchyma (1.59 Ϯ 0.27 ϫ 10 Ϫ5 mm 2 /s) was detected (P Ͻ 0.0001). There were no correlations between the ADC value and prognostic factors. However, the median ADC value was lower in the ER-positive group than the ER negative group, and this difference was marginally significant (1.09 ϫ 10 Ϫ5 mm 2 /s versus 1.15 ϫ 10 Ϫ5 mm 2 /s, P ϭ 0.053). Conclusion:The ADC value was a helpful parameter in detecting malignant breast tumors, but ADC value could not predict patient prognosis. DYNAMIC CONTRAST MATERIAL-enhanced MRI, which gives information on morphology and kinetics and has higher sensitivity, is frequently used to identify additional lesions and to determine the extent of tumor before surgery (1). In recent years, some studies have attempted to differentiate between benign and malignant tumors using diffusion-weighted imaging (DWI) (2-9). DWI is a specific modality that visualizes the microstructural characteristics of water diffusion in biological tissues. The microscopic motion includes the molecular diffusion of water and blood microcirculation in capillary networks; therefore, both diffusion and perfusion affect apparent diffusion coefficient (ADC) values (2,10). The ADC value was determined to be lower in cancer compared with normal parenchyme or benign breast tumor (2-9). Many studies have attempted to predict treatment response and prognosis in patients with breast cancer. It has been disclosed that there are traditional prognostic factors such as tumor grade and molecular markers such as estrogen receptors (ER) and progesterone receptors (PR) (11). Of these prognostic factors, the histologic grade of the tumor and the Ki-67 proliferation index reflect the cellularity (5,8,12,13), and c-erbB-2 and ER are thought to be associated with perfusion (14,15). We have speculated that these prognostic factors can affect the ADC value.To our knowledge, no studies have examined the correlation between the ADC value and prognostic factors. The objectives of the current study are to examine the clinical usefulness of DWI for the detection of invasive cancer, and to determine whether the ADC value can be a new prognostic factor for patients with...

Purpose: To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC mean , ADC minimal ) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma. Materials and Methods:A total of 107 women with invasive ductal cancer underwent breast MRI. The ADC mean and ADC minimal of the cancers were computed. MRI findings were retrospectively evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or nonmass type, mass shape, mass margin, nonmass distribution, and enhancement pattern. Histological records were reviewed for tumor size, lymph node metastasis, histologic grade, and expression of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2(HER2), Ki-67, and epidermal growth factor receptors (EGFR). Correlations of ADC values and MR findings with prognostic factors were determined using the Mann-Whitney U-test and the Kruskal-Wallis test.Results: The mean ADC minimal was 0.78 6 0.24 (Â10 À3 mm 2 /s), and the mean ADC mean was 1.01 6 0.23 (Â10 À3 mm 2 /s). There was a significant correlation of the ADCmean value with ER expression (P ¼ 0.027) and HER2 expression (P ¼ 0.018). There was no significant relationship between ADC minimal and prognostic factors or between ADC mean and traditional prognostic factors, PR, Ki-67 and EGFR. The majority of the mass type lesions were less than 5 cm in size and the majority of nonmass type lesions were more than 2 cm in size (P ¼ 0.022). The margin of mass was significantly associated with lymph node metastasis (P ¼ 0.031), ER expression (P ¼ 0.013), PR expression (P ¼ 0.036), HER2 expression (P ¼ 0.019), and EGRF expression (P ¼ 0.041). The rim internal enhancement was significantly correlated with Ki-67 expression (P ¼ 0.008). Conclusion:The low ADC mean value was related to positive expression of ER and negative expression of HER2. A spiculated margin was related to a good prognosis, but rim enhancement was associated with a poor prognosis.

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There were high degrees of inter- and intraobserver agreement using the "Guidelines for diagnostic thyroid ultrasonography," of the TSGKSNRHNR in the description and categorization of thyroid nodules.

Various ADC parameters were correlated with prognostic factors and subtype, except for ADCmin . HER2 positivity showed high ADC values and high Ki-67 index revealed low ADC values.