A Targeted High-Resolution Axillary MRI to Detect Axillary Lymph Node Metastasis with ADC Values

Yıl 2017, Cilt: 4 Sayı: 2, 17 - 23, 01.08.2017

Turan Ilıca Cem Oren Nurcan Ercıktı Brian Goldner İnanç Guvenc Erkan Ozturk Ali Fuat Cicek Gokhan Osmanoglu Semih Gorgulu

Öz

To evaluate the
clinical utility of ADC values of axillary lymph nodes using high-resolution
axillary MR. 18 women with invasive breast carcinoma underwent axillary MR with
surface coils. Two radiologists determined the most suspicious axillary lymph
node using predefined morphologic descriptors and measured the ADC values of
the most suspicious lymph node in consensus. Statistical analysis was performed
to evaluate the diagnostic value of ADC measurements using the pathologic
assessment as the reference study. Histopathologic findings revealed axillary
nodal metastases in 11 out of 18 patients. ADC values of metastatic lymph nodes
were lower than the nonmetastatic nodes (p=0.006, Mann Whitney U test). By
using 0.967x10^-3 mm²/s as a threshold, sensitivity,
specificity, accuracy, positive predictive value, and negative predictive
values based for ADC were 85.7, 100.0, 94.4, 91.7, 100.0. If our initial
results are confirmed with larger series, ADC values of the axillary lymph
nodes with high-resolution axillary MRI can be an alternative for sentinel
lymph node biopsy.

Anahtar Kelimeler

Apparent Diffusion Coefficient, Axillary Lymph Node, Breast Cancer, Diffusion MRI

Aksiller Lenf Nodu ADC Değerlerinin, Yüksek Rezolüsyonlu MR ile Metastatik Lenf Nodu Tespitinde Kullanımı

Öz

Yüksek rezolüsyonlu MR ile ölçülen aksiller lenf
nodu ADC değerlerinin klinik etkinliğinin araştırılması. İnvaziv meme kanserli
18 kadına yüzeyel koiller ile aksiller MR çekimi yapıldı. İki radyolog
belirlenmiş morfolojik kriterlere göre malignite açısından en şüpheli aksiller
lenf nodunu konsensus ile belirleyerek en şüpheli lenf nodunda ADC ölçümü
yaptılar. Patolojik sonuçlar referans kabul edilerek ADC ölçümlerinin
metastatik-reaktif lenf nodu ayrımında tanısal etkinliğini belirlemede gerekli
istatistik değerlendimeler yapıldı. Histopatolojik bulgular 18 hastanın 11’inde
aksiller lenf nodu metastazı saptadı. Metastatik lenf nodlarının ADC değerleri
olmayanlardan daha düşüktü (p=0.006, Mann Whitney U testi). ADC değerli olarak
0.967x10^-3 mm²/s değeri eşik değer olarak kabul
edildiğinde istatistiksel olarak duyarlılık, özgüllük, doğruluk, pozitif
prediktif ve negatif prediktif değer sırasıyla 85.7, 100.0, 94.4, 91.7, 100.0
olarak belirlendi. Eğer bizim bu konudaki ilk bulgularımız daha geniş seriler
ile desteklenirse yüksek rezolüsyonlu MR ile ölçülen aksiller lenf nodu ADC
değerleri gelecekte sentinel lenf nodu biyopsisine iyi bir alternatif tarama
metodu olabilir.

Anahtar Kelimeler

Aksiller Lenf Nodu, Difüzyon MR, Görünüşteki Difüzyon Katsayısı, Meme Kanseri

Kaynakça

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