Diagnostic value of MRI for predicting axillary lymph nodes metastasis in newly diagnosed breast cancer patients: Diffusion-weighted MRI

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• 作者：Fatma Zaiton^a ; ¹ ; ^{fatmamzaiton@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Samar M. Shehata^a ; ^{samarshehata2003@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mohamad H. Abo Warda^a ; ² ; ^{mohamadwarda_1@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mohamad A. Alekrashy^b ; ³ ; ^{yehiaekrashy2003@yahoo.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：DW-MRI ; diffusion weighted magnetic resonance imaging ; ADC ; apparent diffusion co-efficient ; PPV ; positive predictive value ; NPV ; negative predictive value ; ROC curve ; receiver operating characteristics curve ; HSDWI ; high signal diffusion weighted imaging ; LSDWI ; low signal diffusion weighted imaging ; LNs ; lymph nodes ; N1 (mic) ; microscopic invasion ; DCE-MRI ; dynamic contrast enhanced MRI ; SPAIR ; spectral selective attenuation inversion recovery ; STIR ; short time inversion recovery ; TSE ; turbo s
• 刊名：The Egyptian Journal of Radiology and Nuclear Medicine
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：47
• 期：2
• 页码：659-667
• 全文大小：1531 K

文摘

Non-invasive preoperative detection of axillary nodal metastasis is beneficial for the outcome of breast cancer patients. We aimed to determine the value of DW MRI, ADC and their combination with MRI morphological criteria in detecting axillary metastasis.

Methods

We included recently diagnosed forty breast cancer patients. MRI morphological criteria, signal intensity on DWI, and ADC value were assessed and compared between metastatic and non-metastatic LNs using histopathological findings as reference standard. Sensitivity, specificity, PPV, NPV and accuracy for each variable and cutoff value of ADC were evaluated.

Results

No statistically significant difference between metastatic and non-metastatic LNs in short axis diameter or L/S ratio (p value: 0.87 and 0.82 respectively); however, loss of fatty hilum, high signal intensity on DWI and low ADC value were significant with increasing sensitivity on their combination. The mean ADC was 0.96 ± 0.9 × 10⁻³ mm²/s for metastatic and 1.53 ± 0.6 × 10⁻³ mm²/s for benign LNs with cutoff value 1.09 × 10⁻³ mm²/s and sensitivity (94.5%), specificity (93.6%), PPV (96%), NPV (94.7%) and accuracy (95.6%).

Conclusion

DW-MRI and ADC per se or in combination with loss of the fatty hila is a promising and supportive tool for detection of axillary LNs metastasis.