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  • Title: Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI.
    Author: Kim EJ, Kim SH, Kang BJ, Choi BG, Song BJ, Choi JJ.
    Journal: Magn Reson Imaging; 2014 Dec; 32(10):1230-6. PubMed ID: 25072504.
    Abstract:
    PURPOSES: To evaluate the diagnostic value of diffusion-weighted MRI (DWI) and combination of conventional MRI and DWI to predict metastatic axillary lymph nodes in breast cancer. MATERIALS AND METHODS: Two hundred fifty-two breast cancer patients with 253 axillae were included. The morphological parameters on axial T2-weighted images without fat saturation and apparent diffusion coefficient (ADC) values were retrospectively analyzed. An independent t-test/chi-square test and receiver operating characteristics (ROC) curve analysis were used. RESULTS: On conventional MRI, short and long axis length, maximal cortical thickness, relative T2 value, loss of fatty hilum (p<0.001 for each), and eccentric cortical thickening (p<0.003) were statistically significantly different between the metastatic and nonmetastatic groups. The short axis to long axis ratio was not a statistically significant parameter. The ADC value was significantly different between the 2 groups, with an AUC that was higher than that of conventional MR parameters (AUC, 0.815; threshold, ≤0.986×10-3 mm(2)/sec; sensitivity, 75.8%; specificity, 83.9%). Using the adopted thresholds for each parameter, a total number of findings suggesting malignancy of 4 or higher was determined as the threshold, with high specificity (90.1%). CONCLUSION: Using conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity.
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