Aydin Hale, Guner Bahar, Esen Bostanci Isil, Bulut Zarife Melda, Aribas Bilgin Kadri, Dogan Lutfi, Gulcelik Mehmet Ali
1 Department of Radiology, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey.
2 Department of Pathology, Dr AY Ankara Oncology Research and Training Hospital , Ankara , Turkey.
Br J Radiol. 2018 Apr;91(1084):20170705. doi: 10.1259/bjr.20170705. Epub 2018 Jan 12.
MRI is being used increasingly as a modality that can provide important information about breast cancer. Diffusion-weighted imaging (DWI) is an imaging technique from which apparent diffusion coefficient (ADC) values can be calculated in addition to obtaining important structural information which cannot be obtained from other imaging studies. We did not find any significant relationships between ADC values and prognostic factors, but did provide some explanations for conflicting results in the literature.
The ADC results of 61 females with invasive ductal carcinomas were evaluated. DWI was performed and ADC values were calculated from the area in which restriction of diffusion was the highest in ADC mapping. B value was 500 and region of interest (ROI) was designated between 49 and 100 mm. Calculations were performed automatically by the device. Tissue samples were obtained for prognostic factor evaluation. The relationships between ADC and prognostic factors were investigated. Comparisons between groups were made with one-way ANOVA and Kruskal Wallis test. Pairwise comparisons were made with Dunn's test. Analyses of categorical variables were made with Chi-square test.
We found a weak negative correlation between ADC and Ki-67 values (r = -0.279; p = 0.029). When we compared ADC values in regard to tumour type, we found no significant differences for tumour grade, Ki-67 positivity, estrogen receptor positivity, progesterone receptor positivity, C-erb B2, lymphovascular invasion and ductal carcinoma in situ or lobular carcinoma in situ component. On a side note, we found that mean ADC values decreased as tumour grade increased; however, this was not statistically significant.
The literature contains studies that report conflicting results which may be caused by differences in B values, ROI area and magnetic field strength. Multicentre studies and systematic reviews of these findings may produce crucial data for the use of DWI in breast cancer. Advances in knowledge: To determine if any significant relationship exists between DWI findings and prognostic factors of breast cancer.
磁共振成像（MRI）作为一种能够提供有关乳腺癌重要信息的检查手段，其应用日益广泛。扩散加权成像（DWI）是一种成像技术，除了能获取其他影像学检查无法得到的重要结构信息外，还可计算表观扩散系数（ADC）值。我们未发现ADC值与预后因素之间存在任何显著相关性，但对文献中相互矛盾的结果给出了一些解释。
对61例浸润性导管癌女性患者的ADC结果进行评估。进行DWI检查，并在ADC图上扩散受限最明显的区域计算ADC值。B值为500，感兴趣区（ROI）设定在49至100毫米之间。计算由设备自动完成。获取组织样本进行预后因素评估。研究ADC与预后因素之间的关系。组间比较采用单因素方差分析和Kruskal Wallis检验。两两比较采用Dunn检验。分类变量分析采用卡方检验。
我们发现ADC与Ki-67值之间存在弱负相关（r = -0.279；p = 0.029）。当比较不同肿瘤类型的ADC值时，我们发现肿瘤分级、Ki-67阳性、雌激素受体阳性、孕激素受体阳性、C-erb B2、脉管侵犯以及原位导管癌或原位小叶癌成分方面均无显著差异。顺便提一下，我们发现平均ADC值随肿瘤分级增加而降低；然而，这并无统计学意义。
文献中的研究报告结果相互矛盾，这可能是由于B值、ROI面积和磁场强度的差异所致。对这些结果进行多中心研究和系统评价可能会为DWI在乳腺癌中的应用提供关键数据。知识进展：确定DWI结果与乳腺癌预后因素之间是否存在任何显著关系。
