title: Diagnostic performance of apparent diffusion coefficient and quantitative kinetic parameters for predicting additional malignancy in patients with newly diagnosed breast cancer.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of an apparent diffusion coefficient (ADC) and quantitative kinetic parameters in patients with newly diagnosed breast cancer.
  
  
  METHODS
  We enrolled 169 lesions in 89 patients with breast cancer who underwent dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI). Comparisons between benign and malignant lesions were performed for lesion type (mass or nonmass-like enhancement), size (≥1cm or<1cm), ADC, kinetic parameters and the presence of a US correlate.
  
  
  RESULTS
  There were 63 benign and 106 malignant lesions. The mean size and initial peak enhancement of the benign lesions were significantly lower than those of malignant lesions (P<0.001 for both). The ADC of the benign lesions was significantly higher than that of malignant lesions (1.42×10(-3)mm(2)/sec vs. 1.04×10(-3)mm(2)/sec; P<0.001). The area under the receiver operating characteristic curve (AUC) for predicting malignancy was 0.87 for the combined parameters of size, ADC, and initial peak enhancement, which was higher than those of each parameter.
  
  
  CONCLUSIONS
  Combination of quantitative kinetic parameters and ADC showed higher diagnostic performance for predicting malignancy than each parameter alone for the evaluation of patients with breast cancer.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea; Department of Radiology, Inha University Hospital, College of Medicine, Inhang-Ro 27, Shin-Heung Dong, Joon-Gu, Incheon, South Korea.
authors.forename: Hyunkyung
authors.initials: H
authors.lastname: Yoo
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea. Electronic address: docshin@amc.seoul.kr.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Shin
authors.affiliation: Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea.
authors.forename: Seunghee
authors.initials: S
authors.lastname: Baek
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea.
authors.forename: Joo Hee
authors.initials: JH
authors.lastname: Cha
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea.
authors.forename: Hyunji
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Chae
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea.
authors.forename: Hak Hee
authors.initials: HH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology*; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007700:Kinetics; D008875:Middle Aged; D008954:Models, Biological; D009367:Neoplasm Staging; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Breast; Breast neoplasm; Diffusion-weighted imaging; Dynamic contrast-enhanced MRI