Joao V Horvat1, Manuela Durando1,2, Soledad Milans1,3, Sujata Patil4, Jessica Massler1,5, Girard Gibbons1, Dilip Giri6, Katja Pinker1,7, Elizabeth A Morris1, Sunitha B Thakur8,9. 1. Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 2. Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy. 3. Hospital de Clínicas, University of the Republic, Montevideo, Uruguay. 4. Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 5. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 6. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 7. Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria. 8. Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. thakurs@mskcc.org. 9. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 00 East 66th Street, New York, NY, 10065, USA. thakurs@mskcc.org.
Abstract
OBJECTIVES: To investigate the impact of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT) and menopausal status on apparent diffusion coefficient (ADC) values in differentiation between malignant and benign lesions. METHODS: In this HIPAA-compliant study, mean ADC values of 218 malignant and 130 benign lesions from 288 patients were retrospectively evaluated. The differences in mean ADC values between benign and malignant lesions were calculated within groups stratified by BPE level (high/low), amount of FGT (dense/non-dense) and menopausal status (premenopausal/postmenopausal). Sensitivities and specificities for distinguishing malignant from benign lesions within different groups were compared for statistical significance. RESULTS: The mean ADC value for malignant lesions was significantly lower compared to that for benign lesions (1.07±0.21 x 10-3 mm2/s vs. 1.53±0.26 x 10-3 mm2/s) (p<0.0001). Using the optimal cut-off point of 1.30 x 10-3 mm2/s, an area under the curve of 0.918 was obtained, with sensitivity and specificity both of 87 %. There was no statistically significant difference in sensitivities and specificities of ADC values between different groups stratified by BPE level, amount of FGT or menopausal status. CONCLUSIONS: Differentiation between benign and malignant lesions on ADC values is not significantly affected by BPE level, amount of FGT or menopausal status. KEY POINTS: • ADC allows differentiation between benign and malignant lesions. • ADC is useful for breast cancer diagnosis despite different patient characteristics. • BPE, FGT or menopause do not significantly affect sensitivity and specificity.
OBJECTIVES: To investigate the impact of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT) and menopausal status on apparent diffusion coefficient (ADC) values in differentiation between malignant and benign lesions. METHODS: In this HIPAA-compliant study, mean ADC values of 218 malignant and 130 benign lesions from 288 patients were retrospectively evaluated. The differences in mean ADC values between benign and malignant lesions were calculated within groups stratified by BPE level (high/low), amount of FGT (dense/non-dense) and menopausal status (premenopausal/postmenopausal). Sensitivities and specificities for distinguishing malignant from benign lesions within different groups were compared for statistical significance. RESULTS: The mean ADC value for malignant lesions was significantly lower compared to that for benign lesions (1.07±0.21 x 10-3 mm2/s vs. 1.53±0.26 x 10-3 mm2/s) (p<0.0001). Using the optimal cut-off point of 1.30 x 10-3 mm2/s, an area under the curve of 0.918 was obtained, with sensitivity and specificity both of 87 %. There was no statistically significant difference in sensitivities and specificities of ADC values between different groups stratified by BPE level, amount of FGT or menopausal status. CONCLUSIONS: Differentiation between benign and malignant lesions on ADC values is not significantly affected by BPE level, amount of FGT or menopausal status. KEY POINTS: • ADC allows differentiation between benign and malignant lesions. • ADC is useful for breast cancer diagnosis despite different patient characteristics. • BPE, FGT or menopause do not significantly affect sensitivity and specificity.
Entities:
Keywords:
Breast density; Breast neoplasms; Diagnostic imaging; Diffusion magnetic resonance imaging; Menopause
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