title: Diagnostic Performance of Diffusion Tensor Imaging with Readout-segmented Echo-planar Imaging for Invasive Breast Cancer: Correlation of ADC and FA with Pathological Prognostic Markers.
abstract: OBJECTIVE
  To assess the diagnostic performance of readout-segmented echo-planar diffusion tensor imaging (DTI based on rs-EPI) for breast cancer and to determine the correlation between the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values obtained from DTI based on rs-EPI with prognostic markers of invasive breast cancer.
  
  
  METHODS
  This retrospective study examined 80 pathologically proven breast lesions (22 benign and 58 malignant lesions) of 80 patients who underwent both diffusion-weighted imaging based on single-shot echo-planar imaging (DWI based on ss-EPI) and DTI based on rs-EPI with b-values of 0 and 1000. We identified and compared the diagnostic performances of the DWI based on ss-EPI and the DTI based on rs-EPI using ADCs by conducting a receiver-operating-characteristics (ROC) analysis. We determined the correlations between the ADCs and the prognostic markers and those of the FA values and the same markers.
  
  
  RESULTS
  The median ADCs of the benign and malignant lesions based on the ss-EPI were 1.57 and 1.2 × 10-3mm2/sec, and those based on the rs-EPI were 1.53 and 1.09 × 10-3mm2/sec, respectively. The area under the curve on the ROC analysis based on rs-EPI (0.924) was greater than that based on ss-EPI (0.897). There were no significant correlations between the ADCs and the prognostic markers, but there were significant correlations between the FA values and the estrogen receptor status, a proliferative marker, the nuclear grade and the intrinsic subtype.
  
  
  CONCLUSIONS
  For breast cancer, DTI based on rs-EPI had superior diagnostic performance compared to DWI based on ss-EPI. Compared with the ADCs, the FA values were more closely correlated with prognostic markers of invasive breast cancer.
authors.affiliation: Department of Radiology, Faculty of Medicine, Saga University.
authors.forename: Ken
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Department of Radiology, Faculty of Medicine, Saga University.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nakazono
authors.affiliation: Department of Radiology, Faculty of Medicine, Saga University.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Egashira
authors.affiliation: Siemens Japan K.K. Research & Collaboration Department.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Komori
authors.affiliation: Department of Surgery, Faculty of Medicine, Saga University.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakamura
authors.affiliation: Department of Radiology, Faculty of Medicine, Saga University.|Department of Radiology, National Center for Global Health and Medicine (NCGM).
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Noguchi
authors.affiliation: Department of Radiology, Faculty of Medicine, Saga University.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irie
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
keywords: MRI; breast; diffusion tensor imaging; diffusion-weighted imaging; readout-segmented echo planar imaging