Diagnostic Performance of ADC for Non-mass-like Breast Lesions on MR Imaging
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概要
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We assessed the usefulness and limitations of utilizing apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI) for the differential diagnosis of benign and malignant non-mass-like breast lesions. We retrospectively reviewed 27 such lesions (16 malignant, 11 benign) detected on magnetic resonance (MR) imaging and analyzed the enhancing patterns of dynamic contrast-enhanced DCE-MRI (distribution and internal enhancement), kinetic curve patterns, and ADC values. All images were obtained with a 1.5-tesla MR unit, with patients supine. On DCE-MRI, malignant lesions tended to show either segmental or branching-ductal distribution, and when lesions with these patterns were considered malignant, sensitivity was 68.8%; specificity, 63.6%; positive predictive value (PPV), 73.3%; negative predictive value (NPV), 58.3%; and accuracy, 66.7%. Kinetic curve analysis did not reliably differentiate benign and malignant non-mass-like lesions. There was no significant difference between the mean ADC value of the malignant lesions, 0.968×10−3 mm2/s at b=1000 s/mm2, and that of benign lesions, 1.207×10−3 mm2/s (P=0.109). Receiver operating characteristic (ROC) analysis revealed the most effective threshold of ADC value for differentiating tumors as 1.1×10−3 mm2/s; values lower than this were observed more often in malignant than benign lesions (P=0.054). Us of this threshold yielded sensitivity of 68.8%; specificity, 72.7%; PPV, 78.6%; NPV, 61.5%; and accuracy, 70.4%. Combining the ADC value criteria with the analysis of DCE-MRI pattern increased sensitivity to 93.8%, negative predictive value (NPV) to 85.7%, and accuracy to 77.8% but decreased specificity to 54.5%. Use of ADC values does not adequately improve DCE-MRI performance for differential diagnosis of non-mass-like breast lesions, but adding the ADC value criteria to the DCE-MRI pattern analysis improves sensitivity, NPV, and accuracy.
- 2010-12-01
著者
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Honda Sumihisa
Department Of International Health Institute Of Tropical Medicine Nagasaki University
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HAYASHI Tomayoshi
Nagasaki University Hospital
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Isomoto Ichiro
Department Of Radiology Nagasaki University Graduate School Of Biomedical Sciences
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Yano Hiroshi
Department Of Surgery Ntt West Osaka Hospital
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Abe Kuniko
Department Of Pathology Nagasaki University Hospital
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Abe Kuniko
Department Of Clinical Pathology Nagasaki University Hospital
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Hayashi Tomayoshi
Department Of Cardiovascular Surgery And Pathology Nagasaki University School Of Medicine
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Hayashi Tomayoshi
Deaprtment Of Pathology Nagasaki University Hospital
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Uetani Masataka
Department Of Radiological Sciences Nagasaki University Graduate School Of Biomedical Sciences
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IMAMURA Tsugumi
Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
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SUEYOSHI Eijun
Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
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UGA Tatsuya
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
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YAMAGUCHI Takuma
Department of Radiology, Nagasaki Miharadai Hospital
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Uga Tatsuya
Department Of Surgery Nagasaki University Graduate School Of Biomedical Sciences
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Sueyoshi Eijun
Department Of Radiological Sciences Nagasaki University Graduate School Of Biomedical Sciences
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Imamura Tsugumi
Department Of Radiological Sciences Nagasaki University Graduate School Of Biomedical Sciences
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Yamaguchi Takuma
Department Of Radiology Nagasaki Miharadai Hospital
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Isomoto Ichiro
Department Of Radiological Sciences Nagasaki University Graduate School Of Biomedical Sciences
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Yano Hiroshi
Department Of Surgical Oncology Nagasaki University Graduate School Of Biomedical Sciences
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Hara Takeshi
Department Of Cell Physiology Atomic Disease Institute Nagasaki University School Of Medicine
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Yano Hiroshi
Department Of Agricultural Chemistry Tohoku University
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Uetani Masataka
Department Of Radiological Science Nagasaki University Graduate School Of Biomedical Sciences
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Isomoto Ichiro
Department Of Radiological Science Nagasaki University Graduate School Of Biomedical Sciences
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Honda Sumihisa
Department of Cardiopulmonary Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
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