title: Can Diffusion-Weighted Imaging and Related Apparent Diffusion Coefficient be a Prognostic Value in Women With Breast Cancer?
abstract: OBJECTIVE
  To analyze diffusion-weighted imaging (DWI) and the related apparent diffusion coefficient (ADC) in women with breast cancer, correlating these values with the presence at 3 years of distant metastases, and to demonstrate that DWI-Magnetic Resonance Imaging (MRI) and related ADC values may represent a prognostic value in the study of women with breast cancer.
  
  
  METHODS
  Sixty women (aged 45-73 years) affected with breast cancer with a follow-up in 3 years were enrolled. On DWI, we obtained the ADC values, and these were correlated with the clinical condition of patients at 3 years. Moreover, tumour size, lymph node status, and molecular markers, including estrogens receptor, progesterone receptor, Ki-67 index, and human growth factor receptor 2 protein, were correlated with ADC values. This study was approved by the Scientific Committee of our institution.
  
  
  RESULTS
  We considered patients with metastasis at 3 years (12 patients - 20%) and without metastasis (48 patients - 80%). The mean ADC value in patients with no metastases at 3 years was 1.06 ± 0.38, while for patients with metastases it was 0.74 ± 0.34 (p = .011). The receiver-operator curve analysis identified a value of 0.75 (<0.75 with risk to develop metastasis) as the best predictive cutoff for ADC values, with the highest sensitivity (81.25%) and higher specificity (66.67%). After regression analysis, ADC value, positivity to estrogen-progestin receptors, and presence of lymph nodes were the only prognostic factors found to be statistically significant.
  
  
  CONCLUSIONS
  DWI-MRI and related ADC values may represent a prognostic value in women with breast cancer.
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Rabasco
authors.affiliation: b Department of Radiation Oncology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Rocchina
authors.initials: R
authors.lastname: Caivano
authors.affiliation: c Laboratory of Pre-Clinical and Translational Research , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Simeon
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Dinardo
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Lotumolo
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Gioioso
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Villonio
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Iannelli
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: D'Antuono
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Alexis
authors.initials: A
authors.lastname: Zandolino
authors.affiliation: d Department of Radiology , University of Foggia , Foggia , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Macarini
authors.affiliation: d Department of Radiology , University of Foggia , Foggia , Italy.|e Department of Radiology , Scientific Institute Hospital , "Casa Sollievodella Sofferenza," San Giovanni Rotondo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guglielmi
authors.affiliation: a Department of Radiology , IRCCS - Referral Cancer Center of Basilicata , Rionero in Vulture, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Cammarota
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
keywords: Breast cancer; apparent diffusion coefficient; diffusion-weighted imaging; magnetic resonance imaging; prognostic factors