Role of diffusion-weighted MRI: Predicting axillary lymph node metastases in breast cancer

Jin Chung, Ji Hyun Youk, Jeong Ah Kim, Hye Mi Gweon, Eun Kyung Kim, Young Hoon Ryu, Eun Ju Son

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Ultrasound (US) is probably the standard imaging procedure in most centers, and US-guided fine needle aspiration can be added if suspicious lymph nodes are found. However, US-guided fine needle aspiration is an invasive method to diagnose a metastasis and has showed relatively low sensitivity. In general, diffusion-weighted (DW) magnetic resonance imaging (MRI) has become an emerging technique for discriminating benign from malignant breast lesions in a short imaging acquisition time. Purpose: To evaluate the potential for using DW MRI with an apparent diffusion coefficient (ADC) value to predict axillary lymph node metastases in patients with invasive breast cancer. Material and Methods: This study enrolled 110 axillary lymph nodes from 110 consecutive women who were diagnosed with invasive breast cancer for preoperative breast MRI and US. The largest enhancing ipsilateral axillary lymph nodes were included in this study, and benign and metastatic axillary lymph nodes were compared according to the pathologic reports. The cut-off ADC value to differentiate between benign and metastatic axillary lymph nodes was evaluated with receiver-operating characteristic curve analysis. Diagnostic performance of ultrasound and DW MRI was calculated for enhancing lymph node in dynamic contrast-enhanced MRI. Results: Nodal metastases were documented in 68 (62%) axillary lymph nodes. The mean size of metastatic axillarylymph nodes was larger than that of benign axillary lymph nodes (15.5 mm vs. 10.9 mm, P<0.001). The mean ADC value (0.69×10-3mm2/s) of the metastases was significantly lower than that of the benign axillary lymph nodes (1.04×10-3mm2/s) (P<0.001). The ADC value cut-off between metastatic and benign axillary lymph nodes was 0.90×10-3mm2/s. Using ADC cut-off, sensitivity, specificity, and accuracy of DW MRI were 100%, 83.3%, and 93.6%, respectively. The sensitivity, specificity, and accuracy of US showed 94.1%, 54.8%, and 79.1%, respectively. Conclusion: DW MRI of axillary lymph nodes can provide reliable information for the differentiation of benign from metastatic axillary lymph nodes in invasive breast cancer patients.

Original languageEnglish
Pages (from-to)909-916
Number of pages8
JournalActa Radiologica
Volume55
Issue number8
DOIs
Publication statusPublished - 2013 Jan 1

Fingerprint

Diffusion Magnetic Resonance Imaging
Lymph Nodes
Breast Neoplasms
Neoplasm Metastasis
Fine Needle Biopsy
Magnetic Resonance Imaging
Sensitivity and Specificity
ROC Curve
Ultrasonography
Breast

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Chung, Jin ; Youk, Ji Hyun ; Kim, Jeong Ah ; Gweon, Hye Mi ; Kim, Eun Kyung ; Ryu, Young Hoon ; Son, Eun Ju. / Role of diffusion-weighted MRI : Predicting axillary lymph node metastases in breast cancer. In: Acta Radiologica. 2013 ; Vol. 55, No. 8. pp. 909-916.
@article{7f1cf7ae09274da588c5d6e18ef104e1,
title = "Role of diffusion-weighted MRI: Predicting axillary lymph node metastases in breast cancer",
abstract = "Background: Ultrasound (US) is probably the standard imaging procedure in most centers, and US-guided fine needle aspiration can be added if suspicious lymph nodes are found. However, US-guided fine needle aspiration is an invasive method to diagnose a metastasis and has showed relatively low sensitivity. In general, diffusion-weighted (DW) magnetic resonance imaging (MRI) has become an emerging technique for discriminating benign from malignant breast lesions in a short imaging acquisition time. Purpose: To evaluate the potential for using DW MRI with an apparent diffusion coefficient (ADC) value to predict axillary lymph node metastases in patients with invasive breast cancer. Material and Methods: This study enrolled 110 axillary lymph nodes from 110 consecutive women who were diagnosed with invasive breast cancer for preoperative breast MRI and US. The largest enhancing ipsilateral axillary lymph nodes were included in this study, and benign and metastatic axillary lymph nodes were compared according to the pathologic reports. The cut-off ADC value to differentiate between benign and metastatic axillary lymph nodes was evaluated with receiver-operating characteristic curve analysis. Diagnostic performance of ultrasound and DW MRI was calculated for enhancing lymph node in dynamic contrast-enhanced MRI. Results: Nodal metastases were documented in 68 (62{\%}) axillary lymph nodes. The mean size of metastatic axillarylymph nodes was larger than that of benign axillary lymph nodes (15.5 mm vs. 10.9 mm, P<0.001). The mean ADC value (0.69×10-3mm2/s) of the metastases was significantly lower than that of the benign axillary lymph nodes (1.04×10-3mm2/s) (P<0.001). The ADC value cut-off between metastatic and benign axillary lymph nodes was 0.90×10-3mm2/s. Using ADC cut-off, sensitivity, specificity, and accuracy of DW MRI were 100{\%}, 83.3{\%}, and 93.6{\%}, respectively. The sensitivity, specificity, and accuracy of US showed 94.1{\%}, 54.8{\%}, and 79.1{\%}, respectively. Conclusion: DW MRI of axillary lymph nodes can provide reliable information for the differentiation of benign from metastatic axillary lymph nodes in invasive breast cancer patients.",
author = "Jin Chung and Youk, {Ji Hyun} and Kim, {Jeong Ah} and Gweon, {Hye Mi} and Kim, {Eun Kyung} and Ryu, {Young Hoon} and Son, {Eun Ju}",
year = "2013",
month = "1",
day = "1",
doi = "10.1177/0284185113509094",
language = "English",
volume = "55",
pages = "909--916",
journal = "Acta Radiologica",
issn = "0284-1851",
publisher = "SAGE Publications Ltd",
number = "8",

}

Role of diffusion-weighted MRI : Predicting axillary lymph node metastases in breast cancer. / Chung, Jin; Youk, Ji Hyun; Kim, Jeong Ah; Gweon, Hye Mi; Kim, Eun Kyung; Ryu, Young Hoon; Son, Eun Ju.

In: Acta Radiologica, Vol. 55, No. 8, 01.01.2013, p. 909-916.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Role of diffusion-weighted MRI

T2 - Predicting axillary lymph node metastases in breast cancer

AU - Chung, Jin

AU - Youk, Ji Hyun

AU - Kim, Jeong Ah

AU - Gweon, Hye Mi

AU - Kim, Eun Kyung

AU - Ryu, Young Hoon

AU - Son, Eun Ju

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background: Ultrasound (US) is probably the standard imaging procedure in most centers, and US-guided fine needle aspiration can be added if suspicious lymph nodes are found. However, US-guided fine needle aspiration is an invasive method to diagnose a metastasis and has showed relatively low sensitivity. In general, diffusion-weighted (DW) magnetic resonance imaging (MRI) has become an emerging technique for discriminating benign from malignant breast lesions in a short imaging acquisition time. Purpose: To evaluate the potential for using DW MRI with an apparent diffusion coefficient (ADC) value to predict axillary lymph node metastases in patients with invasive breast cancer. Material and Methods: This study enrolled 110 axillary lymph nodes from 110 consecutive women who were diagnosed with invasive breast cancer for preoperative breast MRI and US. The largest enhancing ipsilateral axillary lymph nodes were included in this study, and benign and metastatic axillary lymph nodes were compared according to the pathologic reports. The cut-off ADC value to differentiate between benign and metastatic axillary lymph nodes was evaluated with receiver-operating characteristic curve analysis. Diagnostic performance of ultrasound and DW MRI was calculated for enhancing lymph node in dynamic contrast-enhanced MRI. Results: Nodal metastases were documented in 68 (62%) axillary lymph nodes. The mean size of metastatic axillarylymph nodes was larger than that of benign axillary lymph nodes (15.5 mm vs. 10.9 mm, P<0.001). The mean ADC value (0.69×10-3mm2/s) of the metastases was significantly lower than that of the benign axillary lymph nodes (1.04×10-3mm2/s) (P<0.001). The ADC value cut-off between metastatic and benign axillary lymph nodes was 0.90×10-3mm2/s. Using ADC cut-off, sensitivity, specificity, and accuracy of DW MRI were 100%, 83.3%, and 93.6%, respectively. The sensitivity, specificity, and accuracy of US showed 94.1%, 54.8%, and 79.1%, respectively. Conclusion: DW MRI of axillary lymph nodes can provide reliable information for the differentiation of benign from metastatic axillary lymph nodes in invasive breast cancer patients.

AB - Background: Ultrasound (US) is probably the standard imaging procedure in most centers, and US-guided fine needle aspiration can be added if suspicious lymph nodes are found. However, US-guided fine needle aspiration is an invasive method to diagnose a metastasis and has showed relatively low sensitivity. In general, diffusion-weighted (DW) magnetic resonance imaging (MRI) has become an emerging technique for discriminating benign from malignant breast lesions in a short imaging acquisition time. Purpose: To evaluate the potential for using DW MRI with an apparent diffusion coefficient (ADC) value to predict axillary lymph node metastases in patients with invasive breast cancer. Material and Methods: This study enrolled 110 axillary lymph nodes from 110 consecutive women who were diagnosed with invasive breast cancer for preoperative breast MRI and US. The largest enhancing ipsilateral axillary lymph nodes were included in this study, and benign and metastatic axillary lymph nodes were compared according to the pathologic reports. The cut-off ADC value to differentiate between benign and metastatic axillary lymph nodes was evaluated with receiver-operating characteristic curve analysis. Diagnostic performance of ultrasound and DW MRI was calculated for enhancing lymph node in dynamic contrast-enhanced MRI. Results: Nodal metastases were documented in 68 (62%) axillary lymph nodes. The mean size of metastatic axillarylymph nodes was larger than that of benign axillary lymph nodes (15.5 mm vs. 10.9 mm, P<0.001). The mean ADC value (0.69×10-3mm2/s) of the metastases was significantly lower than that of the benign axillary lymph nodes (1.04×10-3mm2/s) (P<0.001). The ADC value cut-off between metastatic and benign axillary lymph nodes was 0.90×10-3mm2/s. Using ADC cut-off, sensitivity, specificity, and accuracy of DW MRI were 100%, 83.3%, and 93.6%, respectively. The sensitivity, specificity, and accuracy of US showed 94.1%, 54.8%, and 79.1%, respectively. Conclusion: DW MRI of axillary lymph nodes can provide reliable information for the differentiation of benign from metastatic axillary lymph nodes in invasive breast cancer patients.

UR - http://www.scopus.com/inward/record.url?scp=84910071632&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84910071632&partnerID=8YFLogxK

U2 - 10.1177/0284185113509094

DO - 10.1177/0284185113509094

M3 - Article

C2 - 24234236

AN - SCOPUS:84910071632

VL - 55

SP - 909

EP - 916

JO - Acta Radiologica

JF - Acta Radiologica

SN - 0284-1851

IS - 8

ER -