Rupa R, Thushara R, Swathigha S, Athira R, Meena N, Cherian MP. Diffusion weighted imaging in breast cancer - Can it be a noninvasive predictor of nuclear grade?
Indian J Radiol Imaging 2020;
30:13-19. [PMID:
32476745 PMCID:
PMC7240885 DOI:
10.4103/ijri.ijri_97_19]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/12/2019] [Accepted: 10/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND
DWI and ADC values are noninvasive MRI techniques, which provide quantitative information about tumor heterogeneity.
AIM
To determine the minimum and mean ADC values in breast carcinoma and to correlate ADC values with various prognostic factors.
SETTINGS AND DESIGN
Prospective observational study.
MATERIALS AND METHODS
Fifty-five patients with biopsy-proven breast carcinoma were included in this study. MRI with DWI was performed with Siemens 3T Skyra scanner. ADC values were measured by placing regions of interest (ROIs) within the targeted lesions on ADC maps manually. The histopathological and immunohistochemical analysis of surgical specimen was done to determine the prognostic factors.
STATISTICAL ANALYSIS
Students T test and ANOVA were used to study the difference in ADC between two groups. Pearson correlation coefficient was used to quantify the correlation between ADC values and prognostic factors.
RESULTS
Lower grade (grade I) breast carcinoma had a significantly high ADC value as compared to higher grade carcinoma (grade II and III). For differentiating Grade I tumors from grade II and III, a minimum ADC cut-off value was 0.79 × 10-3 mm2/sec (83% sensitivity and 84% specificity) and a mean ADC cut-off value was 0.82 × 10-3 mm2/sec (83% sensitivity and 71% specificity) was derived. There was no significant correlation between ADC and other prognostic factors.
CONCLUSION
ADC values can be used to differentiate lower grade breast carcinoma (grade I) from higher grades (grade II and III). Minimum ADC values are more accurate in predicting the grade of the breast tumor than mean ADC value.
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