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Clinical Article
Clinical value of intravoxel incoherent motion diffusion-weighted imaging in the diagnosis of small metastatic axillary lymph nodes in breast cancer
JIANG Wei  DENG Hong  ZHANG Xiang  HE Shaoyun  ZHAO Yaqi  GAO Ming 

JIANG W, DENG H, ZHANG X, et al. Clinical value of intravoxel incoherent motion diffusion-weighted imaging in the diagnosis of small metastatic axillary lymph nodes in breast cancer[J]. Chin J Magn Reson Imaging, 2023, 14(9): 70-75, 80. DOI:10.12015/issn.1674-8034.2023.09.012.

[Abstract] Objective To investigate the clinical value of quantitative parameters of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in axillary small metastatic lymph nodes (SMLN) of breast cancer.Materials and Methods Eighty patients with pathologically confirmed breast cancer with axillary SMLN (SMLN group) and 55 patients with benign lymph nodes (BLN) (BLN group) were collected. Conventional MRI and IVIM-DWI sequence scans of bilateral breast and axilla were perform for all patients. The differences in IVIM-DWI parameters true diffusion coefficient (D), perfusion related diffusion coefficient (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) value between SMLN group and BLN group were analyzed and measured accurately. The double exponential nonlinear model parameters (D, D* and f values) and ADC values were drawn to distinguish the ROC curve between the SMLN group and the BLN group with benign breast lesions. The diagnostic effects of axillary SMLN group and axillary BLN in breast cancer were analyzed by area under curve (AUC).Results The D value (F=6.975, P<0.01), D* value (F=3.206, P<0.01) and ADC value (F=5.117, P<0.01) were significantly different, while the f value (F=-0.171, P>0.05) showed no significant difference between SMLN group and BLN group. D value and ADC value were significantly lower in SMLN group than that in BLN group (P<0.001), and D* value was significantly higher in SMLN group than that in BLN group (P=0.002). The AUC values of D, D*, ADC value and the ADC and D combined prediction probability were 0.817, 0.643, 0.734 and 0.833 for differentiating axillary SMLN of breast cancer from BLN of benign breast lesions, respectively. The diagnostic thresholds of D, D* and ADC value were 0.750×10-3 mm2/s, 17.500×10-3 mm2/s, and 0.836×10-3 mm2/s, respectively. The sensitivities were 81.8%, 52.7%, 78.2%, and the specificities were 80.0%, 75.0% and 61.3%, respectively.Conclusions The D value in the diagnosis of breast cancer axillary SMLN has a better diagnostic efficiency and is obviously better than ADC value, which has certain significance for the diagnosis of axillary SMLN.
[Keywords] breast cancer;magnetic resonance imaging;intravoxel incoherent motion;diffusion-weighted imaging;armpit;lymph node metastasis

JIANG Wei   DENG Hong   ZHANG Xiang   HE Shaoyun   ZHAO Yaqi   GAO Ming*  

Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China

Corresponding author: Gao M, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Natural Science Foundation of Guangdong Province (No. 2021A1515010385).
Received  2022-09-04
Accepted  2023-07-21
DOI: 10.12015/issn.1674-8034.2023.09.012
JIANG W, DENG H, ZHANG X, et al. Clinical value of intravoxel incoherent motion diffusion-weighted imaging in the diagnosis of small metastatic axillary lymph nodes in breast cancer[J]. Chin J Magn Reson Imaging, 2023, 14(9): 70-75, 80. DOI:10.12015/issn.1674-8034.2023.09.012.

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