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European Radiology
Published in: European Radiology 2/2016

01-02-2016 | Breast

Peritumoral apparent diffusion coefficients for prediction of lymphovascular invasion in clinically node-negative invasive breast cancer

Authors: Naoko Mori, Shunji Mugikura, Chiaki Takasawa, Minoru Miyashita, Akiko Shimauchi, Hideki Ota, Takanori Ishida, Atsuko kasajima, Kei Takase, Tetsuya Kodama, Shoki Takahashi

Published in: European Radiology | Issue 2/2016

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Abstract

Objectives

To evaluate whether visual assessment of T2-weighted imaging (T2WI) or an apparent diffusion coefficient (ADC) could predict lymphovascular invasion (LVI) status in cases with clinically node-negative invasive breast cancer.

Materials and methods

One hundred and thirty-six patients with 136 lesions underwent MRI. Visual assessment of T2WI, tumour-ADC, peritumoral maximum-ADC and the peritumour-tumour ADC ratio (the ratio between them) were compared with LVI status of surgical specimens.

Results

No significant relationship was found between LVI and T2WI. Tumour-ADC was significantly lower in the LVI-positive (n = 77, 896 ± 148 × 10−6 mm2/s) than the LVI-negative group (n = 59, 1002 ± 163 × 10−6 mm2/s; p < 0.0001). Peritumoral maximum-ADC was significantly higher in the LVI-positive (1805 ± 355 × 10−6 mm2/s) than the LVI-negative group (1625 ± 346 × 10−6 mm2/s; p = 0.0003). Peritumour-tumour ADC ratio was significantly higher in the LVI-positive (2.05 ± 0.46) than the LVI-negative group (1.65 ± 0.40; p < 0.0001). Receiver operating characteristic curve analysis revealed that the area under the curve (AUC) of the peritumour-tumour ADC ratio was the highest (0.81). The most effective threshold for the peritumour-tumour ADC ratio was 1.84, and the sensitivity, specificity, positive predictive value and negative predictive value were 77 % (59/77), 76 % (45/59), 81 % (59/73) and 71 % (45/63), respectively.

Conclusions

We suggest that the peritumour-tumour ADC ratio can assist in predicting LVI status on preoperative imaging.

Key points

• Tumour ADC was significantly lower in LVI-positive than LVI-negative breast cancer.
• Peritumoral maximum-ADC was significantly higher in LVI-positive than LVI-negative breast cancer.
• Peritumour-tumour ADC ratio was significantly higher in LVI-positive breast cancer.
• Diagnostic performance of the peritumour-tumour ADC ratio was highest for positive LVI.
• Peritumour-tumour ADC ratio showed higher diagnostic ability in postmenopausal than premenopausal patients.
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Metadata
Title
Peritumoral apparent diffusion coefficients for prediction of lymphovascular invasion in clinically node-negative invasive breast cancer
Authors
Naoko Mori
Shunji Mugikura
Chiaki Takasawa
Minoru Miyashita
Akiko Shimauchi
Hideki Ota
Takanori Ishida
Atsuko kasajima
Kei Takase
Tetsuya Kodama
Shoki Takahashi
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3847-4

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