Diffusion tensor imaging in differentiation metastatic from reactive axillary lymph nodes in patients with breast cancer

Abstract

Purpose: To determine if diffusion tensor imaging (DTI) parameters can\ndifferentiate metastatic from reactive axillary lymph nodes (ALNs) in\npatients with breast cancer. Methods: Prospective study was done on 48\npatients with breast cancer that were examined by DTI of the breast. The\nmean diffusivity (MD) and fractional anisotropy (FA) of ALNs were\ncalculated by 2 observers. The final diagnosis was obtained by biopsy.\nResults: Metastatic nodes (n=50) had significantly lower MD (p = 0.001,\n0.001) and higher FA (p = 0.002, 0.01) than reactive (n=20) nodes for\nboth observers respectively. When threshed of MD (0.875, 0.815 X10-3\nmm2/s) was used for differentiation of both entities revealed accuracy\n(80 %, 81.4 %) and had AUC of 0.920 and 0.918 by both observers\nrespectively. When threshold FA (0.565, 0.645) was used for\ndifferentiation revealed an accuracy of 87.1%, 81.4% and had AUC of\n0.860 and 0.870 by both observers respectively. Combined FA and MD had\nAUC 0.940, 0.950) with an accuracy of 91.4%, 92.9% for both observers\nrespectively. Conclusion: Combined analysis DTI parameters FA may play a\nrole in differentiation of metastatic from reactive ALNs in patients\nwith breast cancer.