Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI |
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Authors: | Eun Jeong Kim Sung Hun Kim Bong Joo Kang Byung Gil Choi Byung Joo Song Jae Jeong Choi |
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Institution: | 1. Department of Radiology, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea;2. General Surgery, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea;3. Department of Radiology, Dongtan St. Heart Hospital |
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Abstract: | PurposesTo evaluate the diagnostic value of diffusion-weighted MRI (DWI) and combination of conventional MRI and DWI to predict metastatic axillary lymph nodes in breast cancer.Materials and methodsTwo hundred fifty-two breast cancer patients with 253 axillae were included. The morphological parameters on axial T2-weighted images without fat saturation and apparent diffusion coefficient (ADC) values were retrospectively analyzed. An independent t-test/chi-square test and receiver operating characteristics (ROC) curve analysis were used.ResultsOn conventional MRI, short and long axis length, maximal cortical thickness, relative T2 value, loss of fatty hilum (p < 0.001 for each), and eccentric cortical thickening (p < 0.003) were statistically significantly different between the metastatic and nonmetastatic groups. The short axis to long axis ratio was not a statistically significant parameter. The ADC value was significantly different between the 2 groups, with an AUC that was higher than that of conventional MR parameters (AUC, 0.815; threshold, ≤ 0.986 × 10–3 mm2/sec; sensitivity, 75.8%; specificity, 83.9%). Using the adopted thresholds for each parameter, a total number of findings suggesting malignancy of 4 or higher was determined as the threshold, with high specificity (90.1%).ConclusionUsing conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity. |
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Keywords: | Breast neoplasms Lymphatic metastasis Diffusion magnetic resonance imaging Magnetic resonance imaging |
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