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01.11.2014 | Breast | Ausgabe 11/2014

European Radiology 11/2014

Effect of b value and pre-admission of contrast on diagnostic accuracy of 1.5-T breast DWI: a systematic review and meta-analysis

Zeitschrift:
European Radiology > Ausgabe 11/2014
Autoren:
Monique D. Dorrius, Hildebrand Dijkstra, Matthijs Oudkerk, Paul E. Sijens
Wichtige Hinweise
Monique D. Dorrius and Hildebrand Dijkstra contributed equally

Abstract

Objectives

To evaluate the effect of the choice of b values and prior use of contrast medium on apparent diffusion coefficients (ADCs) of breast lesions derived from diffusion-weighted imaging (DWI), and on the discrimination between benign and malignant lesions.

Methods

A literature search of relevant DWI studies was performed. The accuracy of DWI to characterize lesions by using b value ≤600 s/mm2 and b value >600 s/mm2 was presented as pooled sensitivity and specificity, and the ADC was calculated for both groups. Lesions were pooled as pre- or post-contrast DWI.

Results

Of 198 articles, 26 met the inclusion criteria. Median ADCs were significantly higher (13.2–35.1 %, p < 0.001) for the group of b values ≤600 s/mm2 compared to >600 s/mm2. The sensitivity in both groups was similar (91 % and 89 %, p = 0.495) as well as the specificity (75 % and 84 %, p = 0.237). Contrast medium had no significant effects on the ADCs (p ≥ 0.08). The differentiation between benign and malignant lesions was optimal (58.4 %) for the combination of b = 0 and 1,000 s/mm2.

Conclusions

The wide variety of b value combinations applied in different studies significantly affects the ADC of breast lesions and confounds quantitative DWI. If only a couple of b values are used, those of b = 0 and 1,000 s/mm2 are recommended for the best improvement of differentiating between benign and malignant lesions.

Key Points

The choice of b values significantly affects the ADC of breast lesions.
Sensitivity and specificity are not affected by the choice of b values.
b values 0 and 1,000 s/mm 2 are recommended for optimal differentiation between benign and malignant lesions.
Contrast medium prior to DWI does not significantly affect the ADC.

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