Diffusion tensor imaging of breast lesions: evaluation of apparent diffusion coefficient and fractional anisotropy and tissue cellularity

Abstract

To investigate the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) measured by diffusion tensor imaging (DTI), tissue cellularity and their relationship in breast malignant/benign lesions. 88 patients with 88 breast lesions who underwent DTI and dynamic contrast-enhanced MR scanning between November 2013 and December 2014 were retrospectively analyzed. The diagnosis was confirmed pathologically. ADC and FA values as well as histopathological cellularity of different pathological types of lesions were analyzed and compared statistically. The Pearson's correlation between cellularity and ADC and FA was calculated. There were 59 cases of breast cancer and 29 cases of benign lesions included in the study. ADC values of breast cancers were statistically lower than that of benign lesions (p < 0.001). FA and cellularity were higher in cancers than in benign lesions with statistical significance (p < 0.05 and p < 0.001, respectively). The mean FA values in the patients with invasive ductal carcinoma (IDC) were higher than that in the patients with ductal carcinoma in situ (DCIS) without statistical difference (p > 0.05). The ADC and the cellularity in the IDC of grade III were statistically lower (p < 0.05) and higher (p < 0.05) than that in the DCIS and IDC of grade I-II, respectively. ADC was negatively correlated to cellularity (r = -0.8319, p < 0.001) and FA was positively correlated to cellularity (r = 0.4231, p < 0.001). ADC and FA values were statistically different between benign and malignant breast lesions and were significantly correlated to tissue cellularity. ADC and FA may help to discriminate malignant from benign breast lesions and to predict cellularity. ADC is helpful in the prediction of the grade of breast cancer. ADC and FA values were statistically different between benign and malignant breast lesions and were significantly correlated to tissue cellularity.