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European Radiology
Published in: European Radiology 7/2012

01-07-2012 | Breast

Diffusion weighted imaging of the normal breast: reproducibility of apparent diffusion coefficient measurements and variation with menstrual cycle and menopausal status

Authors: Elizabeth A. M. O’Flynn, Veronica A. Morgan, Sharon L. Giles, Nandita M. deSouza

Published in: European Radiology | Issue 7/2012

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Abstract

Objectives

To establish the reproducibility of apparent diffusion coefficient (ADC) measurements in normal fibroglandular breast tissue and to assess variation in ADC values with phase of the menstrual cycle and menopausal status.

Methods

Thirty-one volunteers (13 premenopausal, 18 postmenopausal) underwent magnetic resonance twice (interval 11–22 days) using diffusion-weighted MRI. ADCtotal and a perfusion-insensitive ADChigh (omitting b = 0) were calculated. Reproducibility and inter-observer variability of mean ADC values were assessed. The difference in mean ADC values between the two phases of the menstrual cycle and the postmenopausal breast were evaluated.

Results

ADCtotal and ADChigh showed good reproducibility (r% = 17.6, 22.4). ADChigh showed very good inter-observer agreement (kappa = 0.83). The intraclass correlation coefficients (ICC) were 0.93 and 0.91. Mean ADC values were significantly lower in the postmenopausal breast (ADCtotal 1.46 ± 0.3 × 10-3 mm2/s, ADChigh 1.33 ± 0.3 × 10-3 mm2/s) compared with the premenopausal breast (ADCtotal 1.84 ± 0.26 × 10-3 mm2/s, ADChigh 1.77 ± 0.26 × 10-3 mm2/s; both P < 0.001). No significant difference was seen in ADC values in relation to menstrual cycle (ADCtotal P = 0.2, ADChigh P = 0.24) or between postmenopausal women taking or not taking oestrogen supplements (ADCtotal P = 0.6, ADChigh P = 0.46).

Conclusions

ADC values in fibroglandular breast tissue are reproducible. Lower ADC values within the postmenopausal breast may reduce diffusion-weighted contrast and have implications for accurately detecting tumours.

Key Points

• ADC values from fibroglandular breast tissue are measured reproducibly by multiple observers.
• Mean ADC values were significantly lower in postmenopausal than premenopausal breast tissue.
• Mean ADC values did not vary significantly with menstrual cycle.
• Low postmenopausal ADC values may hinder tumour detection on DW-MRI.
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Metadata
Title
Diffusion weighted imaging of the normal breast: reproducibility of apparent diffusion coefficient measurements and variation with menstrual cycle and menopausal status
Authors
Elizabeth A. M. O’Flynn
Veronica A. Morgan
Sharon L. Giles
Nandita M. deSouza
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2399-0

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