OBJECTIVE: The purpose of our study was to investigate whether adding diffusion-weighted imaging (DWI) to dynamic contrast-enhanced MRI (DCE-MRI) could improve the positive predictive value (PPV) of breast MRI. MATERIALS AND METHODS: The retrospective study included 70 women with 83 suspicious breast lesions on DCE-MRI (BI-RADS 4 or 5) who underwent subsequent biopsy. DWI was acquired during clinical breast MRI using b = 0 and 600 s/mm(2). Apparent diffusion coefficient (ADC) values were compared for benign and malignant lesions. PPV was calculated for DCE-MRI alone (based on biopsy recommendations) and DCE-MRI plus DWI (adding an ADC threshold) for the same set of lesions. Results were further compared by lesion type (mass, nonmasslike enhancement) and size. RESULTS: Of the 83 suspicious lesions, 52 were benign and 31 were malignant (11 ductal carcinoma in situ [DCIS], 20 invasive carcinoma). Both DCIS (mean ADC, 1.31 +/- 0.24 x 10(-3) mm(2)/s) and invasive carcinoma (mean ADC, 1.29 +/- 0.29 x 10(-3) mm(2)/s) exhibited lower mean ADC than benign lesions (1.70 +/- 0.44 x 10(-3) mm(2)/s, p < 0.001). Applying an ADC threshold of 1.81 x 10(-3) mm(2)/s for 100% sensitivity produced a PPV of 47% versus 37% for DCE-MRI alone, which would have avoided biopsy for 33% (17/52) of benign lesions without missing any cancers. DWI increased PPV similarly for masses and nonmasslike enhancement and preferentially improved PPV for smaller (< or = 1 cm) versus larger lesions. CONCLUSION: DWI shows potential for improving the PPV of breast MRI for lesions of varied types and sizes. However, considerable overlap in ADC of benign and malignant lesions necessitates validation of these findings in larger studies.
OBJECTIVE: The purpose of our study was to investigate whether adding diffusion-weighted imaging (DWI) to dynamic contrast-enhanced MRI (DCE-MRI) could improve the positive predictive value (PPV) of breast MRI. MATERIALS AND METHODS: The retrospective study included 70 women with 83 suspicious breast lesions on DCE-MRI (BI-RADS 4 or 5) who underwent subsequent biopsy. DWI was acquired during clinical breast MRI using b = 0 and 600 s/mm(2). Apparent diffusion coefficient (ADC) values were compared for benign and malignant lesions. PPV was calculated for DCE-MRI alone (based on biopsy recommendations) and DCE-MRI plus DWI (adding an ADC threshold) for the same set of lesions. Results were further compared by lesion type (mass, nonmasslike enhancement) and size. RESULTS: Of the 83 suspicious lesions, 52 were benign and 31 were malignant (11 ductal carcinoma in situ [DCIS], 20 invasive carcinoma). Both DCIS (mean ADC, 1.31 +/- 0.24 x 10(-3) mm(2)/s) and invasive carcinoma (mean ADC, 1.29 +/- 0.29 x 10(-3) mm(2)/s) exhibited lower mean ADC than benign lesions (1.70 +/- 0.44 x 10(-3) mm(2)/s, p < 0.001). Applying an ADC threshold of 1.81 x 10(-3) mm(2)/s for 100% sensitivity produced a PPV of 47% versus 37% for DCE-MRI alone, which would have avoided biopsy for 33% (17/52) of benign lesions without missing any cancers. DWI increased PPV similarly for masses and nonmasslike enhancement and preferentially improved PPV for smaller (< or = 1 cm) versus larger lesions. CONCLUSION: DWI shows potential for improving the PPV of breast MRI for lesions of varied types and sizes. However, considerable overlap in ADC of benign and malignant lesions necessitates validation of these findings in larger studies.
Authors: Katja Pinker; Linda Moy; Elizabeth J Sutton; Ritse M Mann; Michael Weber; Sunitha B Thakur; Maxine S Jochelson; Zsuzsanna Bago-Horvath; Elizabeth A Morris; Pascal At Baltzer; Thomas H Helbich Journal: Invest Radiol Date: 2018-10 Impact factor: 6.016
Authors: Sana Parsian; Habib Rahbar; Kimberly H Allison; Wendy B Demartini; Matthew L Olson; Constance D Lehman; Savannah C Partridge Journal: Radiology Date: 2012-10-02 Impact factor: 11.105
Authors: Habib Rahbar; Zheng Zhang; Thomas L Chenevert; Justin Romanoff; Averi E Kitsch; Lucy G Hanna; Sara M Harvey; Linda Moy; Wendy B DeMartini; Basak Dogan; Wei T Yang; Lilian C Wang; Bonnie N Joe; Karen Y Oh; Colleen H Neal; Elizabeth S McDonald; Mitchell D Schnall; Constance D Lehman; Christopher E Comstock; Savannah C Partridge Journal: Clin Cancer Res Date: 2019-01-15 Impact factor: 12.531
Authors: Dorota J Wisner; Nathan Rogers; Vibhas S Deshpande; David N Newitt; Gerhard A Laub; David A Porter; John Kornak; Bonnie N Joe; Nola M Hylton Journal: J Magn Reson Imaging Date: 2013-11-08 Impact factor: 4.813
Authors: Habib Rahbar; Brenda F Kurland; Matthew L Olson; Averi E Kitsch; John R Scheel; Xiaoyu Chai; Joshua Usoro; Constance D Lehman; Savannah C Partridge Journal: J Comput Assist Tomogr Date: 2016 May-Jun Impact factor: 1.826
Authors: Paolo Belli; Melania Costantini; Enida Bufi; Giuseppe Giovanni Giardina; Pierluigi Rinaldi; Gianluca Franceschini; Lorenzo Bonomo Journal: Radiol Med Date: 2014-08-06 Impact factor: 3.469