Diagnostic Significance of Apparent Diffusion Coefficient Values with Diffusion Weighted MRI in Breast Cancer: a Meta-Analysis

Sun, Jiang-Hong; Jiang, Li; Guo, Fei-Ran; Zhang, Xiu-Shi

doi:10.7314/apjcp.2014.15.19.8271

Cited by 9 publications

(7 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering the potential prognostic value of DWI, we finally highlight that a recent systematic review demonstrated that breast lesions with increased signal intensity on DWI and decreased signals on ADC are more likely associated to lymph-nodal metastases (59). …”

Section: Diagnostic Performance Of Dwimentioning

confidence: 99%

Clinical Breast MR Using MRS or DWI: Who Is the Winner?

et al. 2016

View full text Add to dashboard Cite

Magnetic resonance imaging (MRI) of the breast gained a role in clinical practice thanks to the optimal sensitivity of contrast-enhanced (CE) protocols. This approach, first proposed 30 years ago and further developed as bilateral highly spatially resolved dynamic study, is currently considered superior for cancer detection to any other technique. However, other directions than CE imaging have been explored. Apart from morphologic features on unenhanced T2-weighted images, two different non-contrast molecular approaches were mainly run in vivo: proton MR spectroscopy (1H-MRS) and diffusion-weighted imaging (DWI). Both approaches have shown aspects of breast cancer (BC) hidden to CE-MRI: 1H-MRS allowed for evaluating the total choline peak (tCho) as a biomarker of malignancy; DWI showed that restricted diffusivity is correlated with high cellularity and tumor aggressiveness. Secondary evidence on the two approaches is now available from systematic reviews and meta-analyses, mainly considered in this article: pooled sensitivity ranged 71–74% for 1H-MRS and 84–91% for DWI; specificity 78–88% and 75–84%, respectively. Interesting research perspectives are opened for both techniques, including multivoxel MRS and statistical strategies for classification of MR spectra as well as diffusion tensor imaging and intravoxel incoherent motion for DWI. However, when looking at a clinical perspective, while MRS remained a research tool with important limitations, such as relatively long acquisition times, frequent low quality spectra, difficult standardization, and quantification of tCho tissue concentration, DWI has been integrated in the standard clinical protocols of breast MRI and several studies showed its potential value as a stand-alone approach for BC detection.

show abstract

Section: Diagnostic Performance Of Dwimentioning

confidence: 99%

Clinical Breast MR Using MRS or DWI: Who Is the Winner?

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Recent literature reports that DWI with ADC values can be regarded as a useful method in the diagnosis and quantitative measurement of neoplasms (41)(42)(43); in particular, several evidences reported significantly lower ADC values in malignancies than in benign lesions and normal tissues (44,45). The ADC value has also been used to predict nodal metastases in many different cancers and to differentiate malignant from benign lymph nodes in various body regions and organs, such as head and neck, uterine, and cervical cancers (46)(47)(48)(49)(50)(51).…”

Section: Dwi Of Lymph Node Metastases: Current Evidencesmentioning

confidence: 99%

Apparent diffusion coefficient magnetic resonance imaging (ADC-MRI) in the axillary breast cancer lymph node metastasis detection: a narrative review

et al. 2020

View full text Add to dashboard Cite

The presence of axillary lymph nodes metastases in breast cancer is the most significant prognostic factor, with a great impact on morbidity, disease-related survival and management of oncological therapies; for this reason, adequate imaging evaluation is strictly necessary. Physical examination is not enough sensitive to assess breast cancer nodal status; axillary ultrasonography (US) is commonly used to detect suspected or occult nodal metastasis, providing exclusively morphological evaluation, with low sensitivity and positive predictive value. Currently, sentinel lymph node biopsy (SLNB) and/or axillary dissection are the milestone for the diagnostic assessment of axillary lymph node metastases, although its related morbidity. The impact of magnetic resonance imaging (MRI) in the detection of nodal metastases has been widely investigated, as it continues to represent the most promising imaging modality in the breast cancer management. In particular, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values represent additional reliable non-contrast sequences, able to improve the diagnostic accuracy of breast cancer MRI evaluation. Several studies largely demonstrated the usefulness of implementing DWI/ADC MRI in the characterization of breast lesions. Herein, in the light of our clinical experience, we perform a review of the literature regarding the diagnostic performance and accuracy of ADC value as potential pre-operative tool to define metastatic involvement of nodal structures in breast cancer patients.

show abstract

“…A meta-analysis of 624 breast cancer patients from 9 eligible cohort studies, 254 of whom had lymph node metastases (LNMs) and 370 who did not, suggested that ADC values in patients without LNM were higher. 123 A more pressing need in breast cancer is in prognostication, and efforts here have exploited higher field strengths (7 T) to obtain quantitative mpMRI data. A sensitivity of 100%, specificity of 88.2%, has been claimed for a combination of DW-MRI + DCE-MRI, which was greater than for individual parameters (DCE-MRI 100%/53.2%; DW-MRI 93.1%/88.2%) such that it eliminated all false-negative findings and reduced false-positive findings.…”

Section: Value Of Mpmri In Clinical Decision-makingmentioning

confidence: 99%

DCE-MRI, DW-MRI, and MRS in Cancer

Winfield

Payne

Weller

et al. 2016

Topics in Magnetic Resonance Imaging

View full text Add to dashboard Cite

Multi-parametric magnetic resonance imaging (mpMRI) offers a unique insight into tumor biology by combining functional MRI techniques that inform on cellularity (diffusion-weighted MRI), vascular properties (dynamic contrast-enhanced MRI), and metabolites (magnetic resonance spectroscopy) and has scope to provide valuable information for prognostication and response assessment. Challenges in the application of mpMRI in the clinic include the technical considerations in acquiring good quality functional MRI data, development of robust techniques for analysis, and clinical interpretation of the results. This article summarizes the technical challenges in acquisition and analysis of multi-parametric MRI data before reviewing the key applications of multi-parametric MRI in clinical research and practice.

show abstract

Diagnostic Significance of Apparent Diffusion Coefficient Values with Diffusion Weighted MRI in Breast Cancer: a Meta-Analysis

Cited by 9 publications

References 38 publications

Clinical Breast MR Using MRS or DWI: Who Is the Winner?

Clinical Breast MR Using MRS or DWI: Who Is the Winner?

Apparent diffusion coefficient magnetic resonance imaging (ADC-MRI) in the axillary breast cancer lymph node metastasis detection: a narrative review

DCE-MRI, DW-MRI, and MRS in Cancer

Contact Info

Product

Resources

About