dc.contributor.author |
Bickel, Hubert |
dc.contributor.author |
Clauser, Paola |
dc.contributor.author |
Pinker, Katja |
dc.contributor.author |
Helbich, Thomas |
dc.contributor.author |
Biondic, Iva |
dc.contributor.author |
Brkljacic, Boris |
dc.contributor.author |
Dietzel, Matthias |
dc.contributor.author |
Ivanac, Gordana |
dc.contributor.author |
Krug, Barbara |
dc.contributor.author |
Moschetta, Marco |
dc.contributor.author |
Neuhaus, Victor |
dc.contributor.author |
Preidler, Klaus |
dc.contributor.author |
Baltzer, Pascal |
dc.date.accessioned |
2024-04-24T01:05:22Z |
dc.date.available |
2024-04-24T01:05:22Z |
dc.date.issued |
2023-05-11 |
dc.identifier.citation |
Bickel , H , Clauser , P , Pinker , K , Helbich , T , Biondic , I , Brkljacic , B , Dietzel , M , Ivanac , G , Krug , B , Moschetta , M , Neuhaus , V , Preidler , K & Baltzer , P 2023 , ' Introduction of a breast apparent diffusion coefficient category system (ADC-B) derived from a large multicenter MRI database ' , European Radiology , vol. 33 , no. 8 , pp. 5400-5410 . https://doi.org/10.1007/s00330-023-09675-0 |
dc.identifier.issn |
0938-7994 |
dc.identifier.other |
155777144 |
dc.identifier.other |
65dcbc28-e3b5-4bf1-a8ba-aedb82e9ae15 |
dc.identifier.other |
85159347545 |
dc.identifier.other |
37166495 |
dc.identifier.other |
unpaywall: 10.1007/s00330-023-09675-0 |
dc.identifier.uri |
https://hdl.handle.net/20.500.11815/4830 |
dc.description |
Funding Information: The authors would like to thank Joanne Chin, MFA, ELS, for manuscript editing. Publisher Copyright: © 2023, The Author(s). |
dc.description.abstract |
Objectives: To develop an intuitive and generally applicable system for the reporting, assessment, and documentation of ADC to complement standard BI-RADS criteria. Methods: This was a multicentric, retrospective analysis of 11 independently conducted institutional review board–approved studies from seven institutions performed between 2007 and 2019. Breast Apparent Diffusion coefficient (ADC-B) categories comprised ADC-B0 (ADC non-diagnostic), ADC-B1 (no enhancing lesion), and ADC-B2-5. The latter was defined by plotting ADC versus cumulative malignancy rates. Statistics comprised ANOVA with post hoc testing and ROC analysis. p values ≤ 0.05 were considered statistically significant. Results: A total of 1625 patients (age: 55.9 years (± 13.8)) with 1736 pathologically verified breast lesions were included. The mean ADC (× 10−3 mm2/s) differed significantly between benign (1.45, SD.40) and malignant lesions (.95, SD.39), and between invasive (.92, SD.22) and in situ carcinomas (1.18, SD.30) (p <.001). The following ADC-B categories were identified: ADC-B0—ADC cannot be assessed; ADC-B1—no contrast-enhancing lesion; ADC-B2—ADC ≥ 1.9 (cumulative malignancy rate < 0.1%); ADC-B3—ADC 1.5 to < 1.9 (0.1–1.7%); ADC-B4—ADC 1.0 to < 1.5 (10–24.5%); and ADC-B5—ADC < 1.0 (> 24.5%). At the latter threshold, a positive predictive value of 95.8% (95% CI 0.94–0.97) for invasive versus non-invasive breast carcinomas was reached. Conclusions: The breast apparent diffusion coefficient system (ADC-B) provides a simple and widely applicable categorization scheme for assessment, documentation, and reporting of apparent diffusion coefficient values in contrast-enhancing breast lesions on MRI. Clinical relevance statement: The ADC-B system, based on diverse MRI examinations, is clinically relevant for stratifying breast cancer risk via apparent diffusion coefficient measurements, and complements BI-RADS for improved clinical decision-making and patient outcomes. Key Points: • The breast apparent diffusion coefficient category system (ADC-B) is a simple tool for the assessment, documentation, and reporting of ADC values in contrast-enhancing breast lesions on MRI. • The categories comprise ADC-B0 for non-diagnostic examinations, ADC-B1 for examinations without an enhancing lesion, and ADC-B2-5 for enhancing lesions with an increasing malignancy rate. • The breast apparent diffusion coefficient category system may be used to complement BI-RADS in clinical decision-making. |
dc.format.extent |
11 |
dc.format.extent |
1250720 |
dc.format.extent |
5400-5410 |
dc.language.iso |
en |
dc.relation.ispartofseries |
European Radiology; 33(8) |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.subject |
Breast neoplasms |
dc.subject |
Classification |
dc.subject |
Diffusion magnetic resonance imaging |
dc.subject |
Diagnosis, Differential |
dc.subject |
Breast Neoplasms/pathology |
dc.subject |
Humans |
dc.subject |
Middle Aged |
dc.subject |
Breast/diagnostic imaging |
dc.subject |
Magnetic Resonance Imaging |
dc.subject |
Contrast Media |
dc.subject |
Sensitivity and Specificity |
dc.subject |
Diffusion Magnetic Resonance Imaging |
dc.subject |
Female |
dc.subject |
Retrospective Studies |
dc.subject |
Radiology, Nuclear Medicine and Imaging |
dc.title |
Introduction of a breast apparent diffusion coefficient category system (ADC-B) derived from a large multicenter MRI database |
dc.type |
/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article |
dc.description.version |
Peer reviewed |
dc.identifier.doi |
10.1007/s00330-023-09675-0 |
dc.relation.url |
http://www.scopus.com/inward/record.url?scp=85159347545&partnerID=8YFLogxK |
dc.contributor.department |
Faculty of Medicine |