Apparent diffusion coefficient of breast cancer and normal fibroglandular tissue in diffusion-weighted imaging: the effects of menstrual cycle and menopausal status.
The purpose of this study was to investigate prospectively whether the apparent diffusion coefficients (ADCs) of both breast cancer and normal fibroglandular tissue vary with the menstrual cycle and menopausal status. Institutional review board approval was obtained, and informed consent was obtained from each participant. Fifty-seven women (29 premenopausal, 28 postmenopausal) with newly diagnosed breast cancer underwent diffusion-weighted imaging twice (interval 12-20 days) before surgery. Two radiologists independently measured ADC of breast cancer and normal contralateral breast tissue, and we quantified the differences according to the phases of menstrual cycle and menopausal status. With normal fibroglandular tissue, ADC was significantly lower in postmenopausal than in premenopausal women (P = 0.035). In premenopausal women, ADC did not differ significantly between proliferative and secretory phases in either breast cancer or normal fibroglandular tissue (P = 0.969 and P = 0.519, respectively). In postmenopausal women, no significant differences were found between ADCs measured at different time intervals in either breast cancer or normal fibroglandular tissue (P = 0.948 and P = 0.961, respectively). The within-subject variability of the ADC measurements was quantified using the coefficient of variation (CV) and was small: the mean CVs of tumor ADC were 2.90 % (premenopausal) and 3.43 % (postmenopausal), and those of fibroglandular tissue ADC were 4.37 % (premenopausal) and 2.55 % (postmenopausal). Both intra- and interobserver agreements were excellent for ADC measurements, with intraclass correlation coefficients in the range of 0.834-0.974. In conclusion, the measured ADCs of breast cancer and normal fibroglandular tissue were not affected significantly by menstrual cycle, and the measurements were highly reproducible both within and between observers.
Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 1-10, Ami-Dong, Seo-gu, Pusan, 602-739, Republic of Korea. youdosa@naver.com.|Medical Research Institute, Pusan National University School of Medicine, Pusan, Republic of Korea. youdosa@naver.com.
Jin You
JY
Kim
Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 1-10, Ami-Dong, Seo-gu, Pusan, 602-739, Republic of Korea.
Hie Bum
HB
Suh
Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 1-10, Ami-Dong, Seo-gu, Pusan, 602-739, Republic of Korea.
Hyun Jung
HJ
Kang
Medical Research Institute, Pusan National University School of Medicine, Pusan, Republic of Korea.
Jong Ki
JK
Shin
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Ki Seok
KS
Choo
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Kyung Jin
KJ
Nam
Department of Surgery, Pusan National University Hospital, Pusan, Republic of Korea.
Seok Won
SW
Lee
Department of Surgery, Pusan National University Hospital, Pusan, Republic of Korea.
Young Lae
YL
Jung
Department of Surgery, Pusan National University Hospital, Pusan, Republic of Korea.
Young Tae
YT
Bae
D000328:Adult; D000368:Aged; D001940:Breast / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies
Apparent diffusion coefficient; Breast neoplasms; Diffusion-weighted MRI; Menstrual cycle; Reproducibility