Detection of the differences in the apparent diffusion coefficient values in different histopathological types of malignant breast lesions and comparison of cellular region/ stroma ratio and histopathological results

Predictive Value of Early Response to Chemoradiotherapy in Advanced Esophageal Squamous Cell Carcinoma by Diffusion-Weighted MR Imaging

Objective:

To explore the value of diffusion-weighted imaging for early response detection of locally advanced esophageal squamous cell carcinoma with concurrent chemoradiotherapy.

Methods:

Fifty-five (42 males, 13 females) patients with locally advanced esophageal cancer who were undergoing chemoradiotherapy were recruited for this study. Diffusion-weighted imaging was performed in all patients before therapy, at the first weekend, the second weekend, and the end of chemoradiotherapy. The rate of change in apparent diffusion coefficient value and the maximum diameter between pretherapy and posttherapy were calculated.

Results:

Fifty-five patients with locally advanced esophageal squamous cell carcinoma were classified as responders (40 cases) and nonresponders (15 cases). Before chemoradiotherapy, the responders group had a significantly lower apparent diffusion coefficient values than the nonresponders group (t = −4.815, P = .000). At the 3 time points after chemoradiotherapy (first weekend, second weekend, and the end of chemoradiotherapy), there was no statistically significant difference in apparent diffusion coefficient values between responders and nonresponders (P > .05). The responders group had a significantly higher rate of change in apparent diffusion coefficient value than the nonresponders group at each time point (P < .05). At the first weekend of chemoradiotherapy, the rate of change in the maximum diameter was not significantly different in the 2 groups (t = 0.928, P = .357). There was a negative correlation between the tumor apparent diffusion coefficient value of pretherapy and the reduction ratio of tumor maximum diameter at the end of chemoradiotherapy (r = −0.592, P = .000).

Conclusions:

The change rate of apparent diffusion coefficient value by the end of the first week after beginning chemoradiotherapy may be a sensitive indicator to detect the early response to locally advanced esophageal squamous cell carcinoma.

Can apparent diffusion coefficient (ADC) distinguish breast cancer from benign breast findings? A meta-analysis based on 13 847 lesions

BACKGROUND

The purpose of the present meta-analysis was to provide evident data about use of Apparent Diffusion Coefficient (ADC) values for distinguishing malignant and benign breast lesions.

METHODS

MEDLINE library and SCOPUS database were screened for associations between ADC and malignancy/benignancy of breast lesions up to December 2018. Overall, 123 items were identified. The following data were extracted from the literature: authors, year of publication, study design, number of patients/lesions, lesion type, mean value and standard deviation of ADC, measure method, b values, and Tesla strength. The methodological quality of the 123 studies was checked according to the QUADAS-2 instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without any further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malign lesions.

RESULTS

The acquired 123 studies comprised 13,847 breast lesions. Malignant lesions were diagnosed in 10,622 cases (76.7%) and benign lesions in 3225 cases (23.3%). The mean ADC value of the malignant lesions was 1.03 × 10^- 3 mm²/s and the mean value of the benign lesions was 1.5 × 10^- 3 mm²/s. The calculated ADC values of benign lesions were over the value of 1.00 × 10^- 3 mm²/s. This result was independent on Tesla strength, choice of b values, and measure methods (whole lesion measure vs estimation of ADC in a single area).

CONCLUSION

An ADC threshold of 1.00 × 10^- 3 mm²/s can be recommended for distinguishing breast cancers from benign lesions.