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ABSTRACT: To evaluate whether magnetic resonance (MR) imaging features can predict the presence of occult invasion in cases of biopsy-proven pure ductal carcinoma in situ (DCIS).
We retrospectively reviewed 92 biopsy-proven pure DCIS in 92 women who underwent MR imaging. The following MR imaging findings were compared between confirmed DCIS and invasive breast cancer (IBC): lesion size, type, morphological and kinetic assessments by ACR BI-RADS MRI, and findings of fat-suppressed T2-weighted (FS-T2W) imaging.
Sixty-eight of 92 (74%) were non-mass-like enhancements (NMLE) and 24 were mass lesions on MR imaging. Twenty-one of 68 (31%) NMLE and 13 of 24 (54%) mass lesions were confirmed as IBC. In NMLE lesions, large lesions (P = 0.007) and higher signal intensities (SI) on FS-T2W images (P = 0.032) were significantly associated with IBC. Lesion size remained a significant independent predictor of invasion in multivariate analysis (P = 0.032), and combined with FS-T2W SIs showed slightly higher observer performances (area under the curve, AUC, 0.71) than lesion size alone (AUC 0.68). There were no useful findings that enabled the differentiation of mass-type lesions.
Breast MR imaging is potentially useful to predict the presence of occult invasion in biopsy-proven DCIS with NMLE.
MR mammography permits more precise lesion assessment including ductal carcinoma in situ A correct diagnosis of occult invasion before treatment is important for clinicians This study showed the potential of MR mammography to diagnose occult invasion Treatment and/or aggressive biopsy can be given with greater confidence MR mammography can lead to more appropriate management of patients.
European Radiology 12/2011; 22(6):1255-64. · 3.22 Impact Factor
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ABSTRACT: For men with clinically localized prostate cancer and candidates to receive radical prostatectomy (RP) a main concern is a cancer recurrence after treatment. Although previous studies have demonstrated the diagnostic utility of diffusion-weighted imaging (DWI) for prostate cancer, the prognostic value of pretreatment DWI has not been investigated yet.
To investigate the incremental value of MRI-based T staging using DWI and T2-weighted imaging (T2WI) as compared with the clinical parameters in prediction of biochemical recurrence (BCR) after RP for clinically localized prostate cancer.
Sixty MR examinations, obtained before RP between April 2002 and March 2009, were retrospectively reviewed using T2WI alone, DWI alone, or T2WI + DWI for T staging according to the 2002 American Joint Committee on Cancer guidelines. The relationship between MRI stage and BCR was evaluated using Kaplan-Meier survival estimates. Multivariate analysis and receiver operating characteristics (ROC) curve analysis were used to investigate the incremental value over the standard clinical variables in prediction of BCR.
As of August 2009, 12 (20%) patients had BCR. Based on T2WI + DWI, both T3a (compared to OC disease) and T2 (compared to T1c) showed significantly higher BCR rates (p=0.047 and 0.025, respectively). Multivariate analysis and area under ROC curve analysis confirmed the additional value of MRI staging to the conventional clinical variables in prediction of BCR.
The combination of T2WI and DWI on performing pretreatment MRI helped predict BCR after RP in clinically localized prostate cancer.
Acta Radiologica 02/2011; 52(1):120-6. · 1.37 Impact Factor
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ABSTRACT: A 65-year-old woman with resected melanoma underwent F-18 Fluorodeoxyglucose (FDG) PET/CT for the evaluation of a metastatic lesion. Focal increased accumulations were seen in the marrow space of several bones, and interpreted as metastases. MRI demonstrated localized abnormal signal in the corresponding sites.Since she had also suffered from aplastic anemia, additional In-111 chloride bone marrow scintigraphy was performed, and it revealed that the sites with increased accumulation of FDG were consistent with the patchy hematopoietic marrow. FDG PET/CT in a patient with aplastic anemia showing foci of increased bone accumulation occasionally indicates patchy functional hematopoiesis.
Clinical nuclear medicine 12/2009; 34(12):927-30. · 3.92 Impact Factor
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Clinical nuclear medicine 09/2009; 34(8):523-5. · 3.92 Impact Factor
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ABSTRACT: To investigate the effect of gadolinium (Gd)-DTPA on the apparent diffusion coefficient (ADC) of breast carcinoma and to analyze the relationship between pre/postcontrast ADC and the degree of contrast enhancement.
Nineteen histopathologically confirmed breast carcinomas (mean size = 22 mm) were analyzed. Their ADCs before and after contrast administration were measured. The contrast-to-noise ratios (CNRs) of the tumors were measured on fat-suppressed 3D T1-weighted images in precontrast, early, and late postcontrast phases. These results were correlated with the measured ADC values.
A significant decrease in the measured ADC was noted after contrast administration (-23%, P = 0.01). Lesions with relatively high ADC before contrast (>1.3 x 10(-3) mm(2)/sec; n = 12) demonstrated a larger degree of ADC reduction (mean 34%) than lesions with low ADC (< or =1.3 x 10(-3) mm(2)/sec; n = 7) (mean 4.5%). When an early postcontrast image was used as a surrogate marker of malignant potential, we found a significant inverse correlation with postcontrast ADC (gamma = -0.57, P = 0.02).
Postcontrast ADC exhibited lower values than precontrast ADC, which is thought to reflect suppression of the microperfusion-induced effect on diffusion-weighted imaging. Postcontrast ADC may be a better indicator than precontrast ADC to reflect malignant potential of tumors.
Journal of Magnetic Resonance Imaging 05/2009; 29(5):1080-4. · 2.70 Impact Factor
