title: DWI in breast MRI: role of ADC value to determine diagnosis between recurrent tumor and surgical scar in operated patients.
abstract: BACKGROUND
  Purpose of our study is to evaluate the role of the apparent diffusion coefficient (ADC) in the diagnosis of recurrent tumor on the scar in patients operated for breast cancer. Assess, therefore, the weight of diagnostic diffusion echo-planar sequence, in association with the morphological and dynamic sequences in the diagnosis of tumor recurrence versus surgical scar.
  
  
  METHODS
  From September 2007 to March 2009, 72 patients operated for breast cancer with suspected recurrence on the scar were consecutively subjected to magnetic resonance imaging (MRI), including use of a diffusion sequence. All patients with pathological enhancement in the scar were then subjected to histological typing. MRI was considered negative in the absence of areas of suspicious enhancement. In all cases it was measured the ADC value in the scar area or in the area with pathological enhancement. The ADC values were compared with MRI findings and histological results obtained.
  
  
  RESULTS
  26 cases were positive/doubtful at MRI and then subjected to histological typing: of these recurrences were 20 and benign were 6. 46 cases were judged negative at MRI and therefore not sent to cyto-histology. The average ADC value of recurrences was statistically lower of scarring (p<0.001).
  
  
  CONCLUSIONS
  ADC value can be a specific parameter in differential diagnosis between recurrence and scar. The diffusion sequence, in association with the morphological and dynamic sequences, can be considered a promising tool for the surgical indication in suspected recurrence of breast cancer.
authors.affiliation: Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A Gemelli, Lgo A Gemelli 8, 00168 Rome, Italy. pierluigi.rinaldi@rm.unicatt.it
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Rinaldi
authors.forename: Michela
authors.initials: M
authors.lastname: Giuliani
authors.forename: Paolo
authors.initials: P
authors.lastname: Belli
authors.forename: Melania
authors.initials: M
authors.lastname: Costantini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Romani
authors.forename: Daniela
authors.initials: D
authors.lastname: Distefano
authors.forename: Enida
authors.initials: E
authors.lastname: Bufi
authors.forename: Antonino
authors.initials: A
authors.lastname: Mulè
authors.forename: Stefano
authors.initials: S
authors.lastname: Magno
authors.forename: Riccardo
authors.initials: R
authors.lastname: Masetti
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002921:Cicatrix / Q000175:diagnosis*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*