title: Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI.
abstract: OBJECTIVE
  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.
  
  
  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%).
  
  
  CONCLUSIONS
  Using conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity.
authors: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
authors: Eun Jeong
authors: EJ
authors: Kim
authors: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea. Electronic address: rad-ksh@catholic.ac.kr.
authors: Sung Hun
authors: SH
authors: Kim
authors: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
authors: Bong Joo
authors: BJ
authors: Kang
authors: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
authors: Byung Gil
authors: BG
authors: Choi
authors: General Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
authors: Byung Joo
authors: BJ
authors: Song
authors: Department of Radiology, Dongtan St. Heart Hospital.
authors: Jae Jeong
authors: JJ
authors: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000473:pathology*; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Breast neoplasms; Diffusion magnetic resonance imaging; Lymphatic metastasis; Magnetic resonance imaging