title: Detection of invasive components in cases of breast ductal carcinoma in situ on biopsy by using apparent diffusion coefficient MR parameters.
abstract: OBJECTIVE
  To evaluate whether apparent diffusion coefficient (ADC) parameters could identify invasive components in cases with ductal carcinoma in situ (DCIS) diagnosed by biopsy.
  
  
  METHODS
  This retrospective study was approved by the institutional review board and the requirement to obtain informed consent was waived. Sixty-nine consecutive women with 70 lesions diagnosed with DCIS by biopsy underwent breast magnetic resonance (MR) imaging. Multiple regions of interest were placed (as many as possible) within the lesion on ADC maps. The minimum ADC values and the ADC difference values obtained as the difference between minimum and maximum ADCs were evaluated.
  
  
  RESULTS
  Surgical specimens revealed 51 lesions with pure DCIS and the remaining 19 lesions with DCIS with invasive components (DCIS-IC). The minimum ADC value for DCIS-IC (0.99 ± 0.04 × 10(-3) mm(2)/s) was significantly lower than that of pure DCIS (1.15 ± 0.03 × 10(-3) mm(2)/s) (P  =  0.0037). The ADC difference value for DCIS-IC (0.38 ± 0.05 × 10(-3) mm(2)/s) was significantly higher than that of pure DCIS (0.17 ± 0.03 × 10(-3) mm(2)/s). ROC curve analysis for differentiating DCIS-IC from pure DCIS revealed that the area under the curve was 0.71 for minimum ADC value and 0.77 for ADC difference value.
  
  
  CONCLUSIONS
  The minimum ADC values and ADC difference values could suggest the presence of invasive components.
  
  
  CONCLUSIONS
  • Identification of invasive components in DCIS before treatment is clinically important. • Diffusion-weighted MR imaging can help lesion assessment in breast cancer. • The minimum ADC value may suggest the presence of an invasive component in DCIS. • The ADC difference value also suggests the presence of an invasive component in DCIS. • Preoperative evaluation of diffusion-weighted MR imaging may help surgical planning for DCIS.
authors.affiliation: Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Seiryo 1-1, Sendai, 980-8574, Japan, naokomori7127@gmail.com.
authors.forename: Naoko
authors.initials: N
authors.lastname: Mori
authors.forename: Hideki
authors.initials: H
authors.lastname: Ota
authors.forename: Shunji
authors.initials: S
authors.lastname: Mugikura
authors.forename: Chiaki
authors.initials: C
authors.lastname: Takasawa
authors.forename: Junya
authors.initials: J
authors.lastname: Tominaga
authors.forename: Takanori
authors.initials: T
authors.lastname: Ishida
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.forename: Kei
authors.initials: K
authors.lastname: Takase
authors.forename: Shoki
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001943:Breast Neoplasms / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D061705:Image-Guided Biopsy / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity