الفهرس | Only 14 pages are availabe for public view |
Abstract The majority of the lesions that occur in the breast are benign, it is important to recognize benign lesions and distinguish them from breast cancer. Breast cancer is the most commonly diagnosed cancer in females and the second most common cause of death world-wide. Tumor stage at detection is of key influence on survival. Aiming at early detection and ultimately to reduce mortality risk. Contrast-enhanced magnetic resonance imaging represents the gold standard technique in patients with breast cancer. However, two major limitations are represented by its specificity which ranges from 37% to 97% and by the injection of contrast material which increases examination time and costs and may lead to various reactions. These two limitations have been overcome by the introduction of diffusion weighted imaging (DWI) in the field of breast imaging. An important limitation of DWI imaging is represented by respiratory motion which reduces spatial resolution. In order to overcome this discomfort, Takahara et al introduced a new technique named DWIBS, which stands for diffusion-weighted whole body imaging with background body signal suppression.In our thesis, we assessed the sensitivity and specificity of DWIBS as a stand-alone tool without the benefit of DCEMRI images. In this study included 40 patients with 50 breast lesions has been selected and under-went DWIBS after the routine MRI breast protocol which includes T1Wi, T2Wi, STIR, DCEMRI, DWI’s (with ADC map).The histopathology served as reference standard. We found that thirty seven lesions were detected via DWIBS (detectability of 74.0%) is less than that of DWI (detectability of 78.0%). We found that for DWIBS the mean ADCs of the malignant lesions (0.80 ± 0.27 × 10-3mm 2 /s) are significantly lower than those of the benign lesions (1.40 ± 0.41 × 10- 3mm 2 /s). With a cut-off value of 1.3 × 10-3mm 2 /s for ADC, DWIBS achieved 85.7% sensitivity and 80% specificity for differentiating between benign and malignant lesions. In our study, DWIBS showed sensitivity and specificity inferior to DCE-MRI, but it showed comparable sensitivity and specificity with DWI for characterization of the benign and malignant lesions. |