ArticlePloS one2015
Diffusion-Weighted Imaging in 3.0 Tesla Breast MRI: Diagnostic Performance and Tumor Characterization Using Small Subregions vs. Whole Tumor Regions of Interest.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 52 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
52 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Diffusion-Weighted MRI for the Assessment of Molecular Prognostic Biomarkers in Breast Cancer.Korean journal of radiology · 2024Pooled it
- Diffusion-weighted imaging of the breast-a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group.European radiology · 2020Guideline
- Diagnostic performance of breast tumor tissue selection in diffusion weighted imaging: A systematic review and meta-analysis.PloS one · 2020Pooled it
- Can apparent diffusion coefficient (ADC) distinguish breast cancer from benign breast findings? A meta-analysis based on 13 847 lesions.BMC cancer · 2019Pooled it
- Comparison of diffusion-weighted and contrast-enhanced MRI for monitoring response to neoadjuvant therapy in breast cancer.European radiology · 2025Article
- Breast Diffusion-weighted MR Imaging: Current Applications, Insights from Screening, and Future Directions.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2025Review
- Morphological Assessment of Breast Lesions With Type 2 Dynamic Curves Using DWI and T2WI Based on Breast Imaging Reporting and Data System Lexicon Descriptors.The breast journal · 2025Article
- DWI in the Differentiation of Malignant and Benign Breast Lesions Presenting with Non-Mass Enhancement on CE-MRI.Cancers · 2024Article
- Article
- Diffusion-Weighted Imaging for Skin Pathologies of the Breast-A Feasibility Study.Diagnostics (Basel, Switzerland) · 2024Article
- Diffusion weighted imaging for improving the diagnostic performance of screening breast MRI: impact of apparent diffusion coefficient quantitation methods and cutoffs.Frontiers in oncology · 2024Article
- Update on DWI for Breast Cancer Diagnosis and Treatment Monitoring.AJR. American journal of roentgenology · 2024Review
- A risk prediction stratification for non-mass breast lesions, combining clinical characteristics and imaging features on ultrasound, mammography, and MRI.Frontiers in oncology · 2024Article
- Article
- Neoadjuvant chemotherapy induces an elevation of tumour apparent diffusion coefficient values in patients with ovarian cancer.BMC cancer · 2023Article
- Article
- Article
- Safely reducing unnecessary benign breast biopsies by applying non-mass and DWI directional variance filters to ADC thresholding.BMC medical imaging · 2022Article
- Breast Cancer Subtypes and Quantitative Magnetic Resonance Imaging: A Systemic Review.Life (Basel, Switzerland) · 2022Review
- Using the apparent diffusion coefficient histogram analysis to predict response to neoadjuvant chemotherapy in patients with breast cancer: comparison among three region of interest selection methods.Annals of translational medicine · 2022Article
Corrections and comments
- Erratum issuedCorrection: Diffusion-Weighted Imaging in 3.0 Tesla Breast MRI: Diagnostic Performance and Tumor Characterization Using Small Subregions vs. Whole Tumor Regions of Interest.2015 · Arponent, Otso [corrected to Arponen, Otso]
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionApparent diffusion coefficient (ADC) values are increasingly reported in breast MRI. As there is no standardized method for ADC measurements, we evaluated the effect of the size of region of interest (ROI) to diagnostic utility and correlation to prognostic markers of breast cancer.
methodsThis prospective study was approved by the Institutional Ethics Board; the need for written informed consent for the retrospective analyses of the breast MRIs was waived by the Chair of the Hospital District. We compared diagnostic accuracy of ADC measurements from whole-lesion ROIs (WL-ROIs) to small subregions (S-ROIs) showing the most restricted diffusion and evaluated correlations with prognostic factors in 112 consecutive patients (mean age 56.2±11.6 years, 137 lesions) who underwent 3.0-T breast MRI.
resultsIntra- and interobserver reproducibility were substantial (κ = 0.616-0.784; Intra-Class Correlation 0.589-0.831). In receiver operating characteristics analysis, differentiation between malignant and benign lesions was excellent (area under curve 0.957-0.962, cut-off ADC values for WL-ROIs: 0.87×10-3 mm2s-1; S-ROIs: 0.69×10-3 mm2s-1, P<0.001). WL-ROIs/S-ROIs achieved sensitivities of 95.7%/91.3%, specificities of 89.5%/94.7%, and overall accuracies of 89.8%/94.2%. In S-ROIs, lower ADC values correlated with presence of axillary metastases (P = 0.03), high histological grade (P = 0.006), and worsened Nottingham Prognostic Index Score (P<0.05). In both ROIs, ADC values correlated with progesterone receptors and advanced stage (P<0.01), but not with HER2, estrogen receptors, or Ki-67.
conclusionsADC values assist in breast tumor characterization. Small ROIs were more accurate than whole-lesion ROIs and more frequently associated with prognostic factors. Cut-off values differed significantly depending on measurement procedure, which should be recognized when comparing results from the literature. Instead of using a whole lesion covering ROI, a small ROI could be advocated in diffusion-weighted imaging.
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