Rupa R, Thushara R, Swathigha S, Athira R, Meena N, Cherian Mathew P
Division of Breast Imaging, Department of Diagnostic and Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India.
Indian J Radiol Imaging. 2020 Jan-Mar;30(1):13-19. doi: 10.4103/ijri.IJRI_97_19. Epub 2020 Mar 30.
DWI and ADC values are noninvasive MRI techniques, which provide quantitative information about tumor heterogeneity.
To determine the minimum and mean ADC values in breast carcinoma and to correlate ADC values with various prognostic factors.
Prospective observational study.
Fifty-five patients with biopsy-proven breast carcinoma were included in this study. MRI with DWI was performed with Siemens 3T Skyra scanner. ADC values were measured by placing regions of interest (ROIs) within the targeted lesions on ADC maps manually. The histopathological and immunohistochemical analysis of surgical specimen was done to determine the prognostic factors.
Students T test and ANOVA were used to study the difference in ADC between two groups. Pearson correlation coefficient was used to quantify the correlation between ADC values and prognostic factors.
Lower grade (grade I) breast carcinoma had a significantly high ADC value as compared to higher grade carcinoma (grade II and III). For differentiating Grade I tumors from grade II and III, a minimum ADC cut-off value was 0.79 × 10-3 mm/sec (83% sensitivity and 84% specificity) and a mean ADC cut-off value was 0.82 × 10-3 mm/sec (83% sensitivity and 71% specificity) was derived. There was no significant correlation between ADC and other prognostic factors.
ADC values can be used to differentiate lower grade breast carcinoma (grade I) from higher grades (grade II and III). Minimum ADC values are more accurate in predicting the grade of the breast tumor than mean ADC value.
扩散加权成像（DWI）和表观扩散系数（ADC）值是无创性磁共振成像（MRI）技术，可提供有关肿瘤异质性的定量信息。
确定乳腺癌的最小和平均ADC值，并将ADC值与各种预后因素相关联。
前瞻性观察性研究。
本研究纳入了55例经活检证实的乳腺癌患者。使用西门子3T Skyra扫描仪进行DWI的MRI检查。通过在ADC图上手动将感兴趣区（ROI）放置在目标病变内来测量ADC值。对手术标本进行组织病理学和免疫组织化学分析以确定预后因素。
采用学生t检验和方差分析研究两组之间ADC的差异。使用Pearson相关系数量化ADC值与预后因素之间的相关性。
与高级别癌（II级和III级）相比，低级别（I级）乳腺癌的ADC值显著更高。为了区分I级肿瘤与II级和III级肿瘤，得出最小ADC临界值为0.79×10⁻³mm²/sec（灵敏度83%，特异性84%），平均ADC临界值为0.82×10⁻³mm²/sec（灵敏度83%，特异性71%）。ADC与其他预后因素之间无显著相关性。
ADC值可用于区分低级别乳腺癌（I级）与高级别（II级和III级）。最小ADC值在预测乳腺肿瘤分级方面比平均ADC值更准确。
