Apparent diffusion coefficient in estrogen receptor-positive invasive ductal breast carcinoma: correlations with tumor-stroma ratio.
OBJECTIVE
To determine whether apparent diffusion coefficient (ADC) values vary according to tumor-stroma ratio, dominant stroma type, or presence of central fibrosis in estrogen receptor-positive breast cancer.


METHODS
Institutional review board approval was obtained, and patient consent was waived. Sixty-one patients with estrogen receptor-positive invasive ductal carcinoma-not otherwise specified who underwent breast magnetic resonance (MR) imaging with diffusion-weighted (DW) imaging were included in this study. The ADC values of the lesions were measured. Two pathologists evaluated the tumor-stroma ratio, dominant stroma type (collagen, fibroblast, lymphocyte), and central fibrosis. Detectability on DW images was compared between the two groups according to the tumor-stroma ratio (stroma rich or stroma poor). Mean ADC values were retrospectively compared with the tumor-stroma ratio, dominant stroma type, and presence of a central fibrosis. Multiple linear regression analysis was performed to determine variables independently associated with ADC.


RESULTS
On DW images, detectability was not significantly different between stroma-rich and stroma-poor groups (P = .244). ADC values were significantly lower in the stroma-poor group (P < .001). The mean ADC values in the collagen-dominant type were lower than in fibroblast-dominant or lymphocyte-dominant types (P = .021). In multiple linear regression analysis, tumor-stroma ratio (P = .007), tumor size (P = .007), and dominant stroma type (collagen dominant, P = .029) were independently correlated with ADC.


CONCLUSIONS
In estrogen receptor-positive breast cancers, ADC values showed significant differences according to the tumor-stroma ratio and dominant stroma type.
From the Departments of Radiology (E.S.K., B.K.H., E.Y.K., J.H.S., S.Y.H.), Pathology (E.Y.C., S.A.), and Surgery (S.J.N.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea; and Department of Preventive Medicine, Dong-A University School of Medicine, Busan, South Korea (R.B.K.).
Eun Sook
ES
Ko
Boo-Kyung
BK
Han
Rock Bum
RB
Kim
Eun Yoon
EY
Cho
Soomin
S
Ahn
Seok Jin
SJ
Nam
Eun Young
EY
Ko
Jung Hee
JH
Shin
Soo Yeon
SY
Hahn
D000368:Aged; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D011986:Receptors, Somatotropin / Q000378:metabolism; D012189:Retrospective Studies; D059016:Tumor Microenvironment
D003287:Contrast Media; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D011986:Receptors, Somatotropin