Diagnostic performance of diffusion tensor imaging parameters in breast cancer and correlation with the prognostic factors.
To evaluate the diagnostic performances of the diffusion tensor imaging (DTI) parameters in the diagnosis of breast cancer and to investigate the variations in DTI parameters according to the breast cancer biomarkers.



At 3.0 Tesla (T), DTI was performed in 85 patients with 92 enhancing breast lesions. λ1, λ2, λ3, mean diffusivity (MD), radial diffusivity (RD), fractional anisotropy (FA), relative anisotropy (RA), and geodesic anisotropy (GA) were studied and compared with diffusion-weighted imaging-derived apparent diffusion coefficient. Lesions were analyzed according to BIRADS lexicon. Logistic regression models were constructed to determine the contribution of DTI to the specificity and the accuracy of DCE-MRI. Breast cancer biomarkers; estrogen receptor (ER), HER-2 status, and Ki-67 were correlated with DTI in malignant cases.



Malignant lesions exhibited significantly lower MD, RD, λ1, λ2, λ3and higher FA, RA, GA values (P <  0.001). Logistic regression models showed that MD, RD, λ1, λ2, λ3, FA, and RA increase the specificity of the DCE-MRI (from 83.0% to 89.4-93.6%; P <  0.05). Higher RD, λ2, λ3and lower FA, RA, and GA values were observed in ER-negative breast cancer (P <  0.05). Ki-67 showed significant, negative correlation with FA, RA, GA, λ1-λ3and λ1-λ2(r = -0.336 to -0.435; P <  0.05).



Besides its ability to differentiate malignant breast lesions, DTI improves the specificity of conventional 3.0T breast MRI and shows correlation with biomarkers ER and Ki-67.



1 J. Magn. Reson. Imaging 2017;45:660-672.
Oberlausitz-Kliniken gGmbH, Institute of Diagnostic and Interventional Radiology, Bautzen, Germany.
Can
C
Onaygil
Marmara University School of Medicine, Department of Pathology, Pendik, Istanbul, Turkey.
Handan
H
Kaya
Marmara University School of Medicine, Department of General Surgery, Pendik, Istanbul, Turkey.
Mustafa Umit
MU
Ugurlu
Marmara University School of Medicine, Department of Radiology, Pendik, Istanbul, Turkey.
Erkin
E
Aribal
D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism; D056324:Diffusion Tensor Imaging / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
D014408:Biomarkers, Tumor
apparent diffusion coefficient; breast; diffusion tensor imaging; diffusion-weighted imaging; fractional anisotropy; magnetic resonance imaging