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Preoperative Prediction of Ductal Carcinoma in situ Underestimation of the Breast using Dynamic Contrast Enhanced and Diffusion-weighted Imaging

Other Titles
 역동적 유방 자기공명 영상 및 확산 강조영상을 이용한 관상피내암종 저평가 수술전 예측 
 Mina Park ; Eun-Kyung Kim ; Hee Jung Moon ; Min Jung Kim 
 Journal of the Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회지), Vol.17(2) : 101~109, 2013 
Journal Title
 Journal of the Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회지) 
Issue Date
Objective To investigate roles of dynamic contrast enhanced magnetic resonance (DCE MR) and diffusion-weighted (DW) imaging in preoperative prediction of underestimation of ductal carcinoma in situ (DCIS)≥2cm on US guided core needle biopsy. Materials and Methods Twenty two patients with DCIS on US-guided 14 gauge core needle biopsy were included. Patients were divided into a group with and without DCIS underestimation based on histopathology. MR images including DCE and DW imaging were obtained with a 3.0-T MR. The lesion type (mass or non-mass), enhancement pattern, peak enhancement, and apparent diffusion coefficient (ADC) values of proven malignant masses were generated using software of CADstream and compared between two groups using Fisher's exact test and Mann Whitney test. Results Eight patients were in the group with underestimation and 14 patients were in the group without underestimation. The lesion type and enhancement pattern were not different between two groups (P values = 1.000 and 0.613, respectively). The median peak enhancement of lesions with underestimation was 159.5%, higher than 133.5% of those without underestimation, but not significant (P value = 0.413). The median ADC value of lesions with underestimation was 1.26×10-3 mm2/sec, substantially lower than 1.35×10-3 mm2/sec of those without underestimation (P value = 0.094). Conclusion ADC values had the potential to preoperatively predict DCIS underestimation on US-guided core needle biopsy, although a large prospective series study should be conducted to confirm these results.
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