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Peritumoral apparent diffusion coefficients for prediction of lymphovascular invasion in clinically node-negative invasive breast cancer

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An Erratum to this article was published on 03 July 2015

Abstract

Objectives

To evaluate whether visual assessment of T2-weighted imaging (T2WI) or an apparent diffusion coefficient (ADC) could predict lymphovascular invasion (LVI) status in cases with clinically node-negative invasive breast cancer.

Materials and methods

One hundred and thirty-six patients with 136 lesions underwent MRI. Visual assessment of T2WI, tumour-ADC, peritumoral maximum-ADC and the peritumour-tumour ADC ratio (the ratio between them) were compared with LVI status of surgical specimens.

Results

No significant relationship was found between LVI and T2WI. Tumour-ADC was significantly lower in the LVI-positive (n = 77, 896 ± 148 × 10−6 mm2/s) than the LVI-negative group (n = 59, 1002 ± 163 × 10−6 mm2/s; p < 0.0001). Peritumoral maximum-ADC was significantly higher in the LVI-positive (1805 ± 355 × 10−6 mm2/s) than the LVI-negative group (1625 ± 346 × 10−6 mm2/s; p = 0.0003). Peritumour-tumour ADC ratio was significantly higher in the LVI-positive (2.05 ± 0.46) than the LVI-negative group (1.65 ± 0.40; p < 0.0001). Receiver operating characteristic curve analysis revealed that the area under the curve (AUC) of the peritumour-tumour ADC ratio was the highest (0.81). The most effective threshold for the peritumour-tumour ADC ratio was 1.84, and the sensitivity, specificity, positive predictive value and negative predictive value were 77 % (59/77), 76 % (45/59), 81 % (59/73) and 71 % (45/63), respectively.

Conclusions

We suggest that the peritumour-tumour ADC ratio can assist in predicting LVI status on preoperative imaging.

Key points

• Tumour ADC was significantly lower in LVI-positive than LVI-negative breast cancer.

• Peritumoral maximum-ADC was significantly higher in LVI-positive than LVI-negative breast cancer.

• Peritumour-tumour ADC ratio was significantly higher in LVI-positive breast cancer.

• Diagnostic performance of the peritumour-tumour ADC ratio was highest for positive LVI.

• Peritumour-tumour ADC ratio showed higher diagnostic ability in postmenopausal than premenopausal patients.

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Abbreviations

ADC:

Apparent diffusion coefficient

DWI:

Diffusion-weighted imaging

Her2:

Human epidermal growth factor receptor 2

LVI:

Lymphovascular invasion

MRI:

Magnetic resonance imaging

NOS:

Not otherwise specified

T2WI:

T2-weighted imaging

ROI:

Region of interest

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Acknowledgements

The authors thank Tatsuo Nagasaka, RT, Kazuomi Yamanaka, RT, Hironobu Sasaki, RT, Tomoyoshi Kimura, RT, of Tohoku University Hospital, Sendai, Japan, for their excellent technical assistance and kind support. The scientific guarantor of this publication is Shoki Takahashi. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, diagnostic, performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Seiryo 1-1, Sendai, 980-8574, Japan

    Naoko Mori, Shunji Mugikura, Chiaki Takasawa, Akiko Shimauchi, Hideki Ota, Kei Takase & Shoki Takahashi

  2. Department of Surgical Oncology, Tohoku University Graduate School of Medicine, Seiryo 1-1, Sendai, 980-8574, Japan

    Minoru Miyashita & Takanori Ishida

  3. Department of Pathology, Tohoku University Graduate School of Medicine, Seiryo 1-1, Sendai, 980-8574, Japan

    Atsuko kasajima

  4. Department of Biomedical Engineering, Tohoku University Graduate School of Medicine, Seiryo 1-1, Sendai, 980-8574, Japan

    Tetsuya Kodama

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  1. Naoko Mori
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  2. Shunji Mugikura
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Correspondence to Naoko Mori.

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Mori, N., Mugikura, S., Takasawa, C. et al. Peritumoral apparent diffusion coefficients for prediction of lymphovascular invasion in clinically node-negative invasive breast cancer. Eur Radiol 26, 331–339 (2016). https://doi.org/10.1007/s00330-015-3847-4

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