| Apparent Diffusion Coefficient as an MR Imaging Biomarker of Low-Risk Ductal Carcinoma in Situ: A Pilot Study. | |
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MedLine Citation:
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PMID: 21633054 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Purpose: To evaluate the potential of apparent diffusion coefficients (ADCs) obtained at quantitative diffusion-weighted magnetic resonance (MR) imaging of the breast as a biomarker of low-grade ductal carcinoma in situ (DCIS). Materials and Methods: This retrospective study was approved by an institutional review board, and the requirement to obtain informed consent was waived. Twenty-two women (age range, 36-75 years; mean age, 56.4 years) with pure DCIS (seven with low-grade DCIS, five with intermediate-grade DCIS, and seven with high-grade DCIS) and three with microinvasion underwent breast MR imaging at 1.5 T between January 2008 and November 2010. MR examinations included contrast material-enhanced (gadoteridol) T1-weighted imaging and diffusion-weighted MR imaging with b values of 0 and 1000 sec/mm(2). ADC maps were generated. The distributions of the ADCs in regions of interest covering the lesions were compared among the three grades by using linear mixed-model analysis, and the discriminatory power of the lesion minimum ADC was determined with receiver operating characteristic analysis. Results: The mean ADC was 1.42 × 10(-3) mm(2)/sec (95% confidence interval [CI]: 1.31 × 10(-3) mm(2)/sec, 1.54 × 10(-3) mm(2)/sec) for low-grade DCIS, 1.23 × 10(-3) mm(2)/sec (95% CI: 1.10 × 10(-3) mm(2)/sec, 1.36 × 10(-3) mm(2)/sec) for intermediate-grade DCIS, 1.19 × 10(-3) mm(2)/sec (95% CI: 1.08 × 10(-3) mm(2)/sec, 1.30 × 10(-3) mm(2)/sec) for high-grade DCIS, and 2.06 × 10(-3) mm(2)/sec (95% CI: 1.94 × 10(-3) mm(2)/sec, 2.18 × 10(-3) mm(2)/sec) for normal breast tissue. The mean ADCs for high- and intermediate-grade DCIS were significantly lower than that for low-grade DCIS (P < .01 and P = .03, respectively), and the mean ADC for low-grade DCIS was significantly lower than that for normal tissue (P < .001). The lesion minimum ADC for low-grade DCIS was also significantly higher than that for high- and intermediate-grade DCIS (P < .01). A threshold of 1.30 × 10(-3) mm(2)/sec for the minimum ADC in the diagnosis of low-grade DCIS had a specificity of 100% (12 of 12 patients; 95% CI: 73.5%, 100%) and a positive predictive value of 100% (four of four patients; 95% CI: 39.8%, 100%). Conclusion: These preliminary results suggest that quantitative diffusion-weighted MR imaging could be used to identify patients with low-grade DCIS with very high specificity. If the results of this study are confirmed, this approach could potentially spare those patients from invasive approaches such as mastectomy or axillary lymph node excision. © RSNA, 2011. |
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Authors:
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Mami Iima; Denis Le Bihan; Ryosuke Okumura; Tomohisa Okada; Koji Fujimoto; Shotaro Kanao; Shiro Tanaka; Masakazu Fujimoto; Hiromi Sakashita; Kaori Togashi |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-1 |
Journal Detail:
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Title: Radiology Volume: - ISSN: 1527-1315 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Diagnostic Imaging and Nuclear Medicine and Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Shogoin Kawaharacho, Sakyoku, Kyoto 606-8507, Japan; Departments of Radiology and Pathology, Kitano Hospital, Osaka, Japan; Neurospin, CEA-Saclay, Gif-sur-Yvette, France. |
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