Wan CWS, Lee CY, Lui CY, Fong CY, Lau KCH. Apparent diffusion coefficient in differentiation between malignant and benign breast masses: does size matter?
Clin Radiol 2015;
71:170-7. [PMID:
26688549 DOI:
10.1016/j.crad.2015.11.006]
[Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 10/02/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
AIM
To determine whether lesion size affects the diagnostic performance of apparent diffusion coefficient (ADC) in the evaluation of breast masses.
MATERIALS AND METHODS
Consecutive breast lesions detected at magnetic resonance imaging (MRI) from June 2010 to July 2013 were retrospectively reviewed. Differences in the ADCs of benign and malignant mass lesions were compared. Receiver operating characteristics analysis was performed to evaluate diagnostic performance of ADC regarding lesion size (≤ 1 cm or >1 cm) and their T2W signal intensities.
RESULTS
Seventy-four malignant lesions (77.9%) and 21 (22.1%) benign lesions were included. Twenty-two of the 95 (23.2%) masses measured ≤ 1 cm (mean 0.73 ± 0.4; range 0.51-0.8 cm) and 73/95 (76.9%) masses measured >1 cm (mean 2.11 ± 0.1; range 1.1-3.3 cm). The mean ADC was significantly lower for malignant than for benign lesions (mean for malignant lesion, 0.89 ± 0.29 × 10(-3) mm(2)/s; mean for benign lesions, 1.27 ± 0.42 × 10(-3) mm(2)/s; p<0.01). The optimal ADC cut-off for differentiating benign and malignant lesion was 1.088 × 10(-3) mm(2)/s with a sensitivity of 85.9% and specificity of 77% for lesions >1 cm. The sensitivity and specificity were lowered to 60% and 50%, respectively, for lesions of size ≤ 1. Maximal sensitivity and specificity were reached when the ADC value was used to evaluate T2-dark lesions.
CONCLUSION
Diffusion-weighted MRI is useful for characterizing masses that are hypointense on T2-weighted images. Lower sensitivity and specificity were found for breast lesions ≤ 1 cm.
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