| Summary: | Purpose: To detect axillary lymph node metastasis based on diffusion Weighted MR and apparent diffusion coefficient (ADC) in the known breast cancer cases.
Patient and methods: Forty-four patients were included in this study for preoperative MRI staging of the breast cancer and axillary lymph node assessment. The lymph node criteria (long/short-axis ratio, T2WI, DWI and ADC value) were included in the analysis. Images were obtained with diffusion sensitizing gradients of 0 and 750 mm2/s. The ADC was calculated.
Results: Thirty-two patients had metastatic axillary lymph nodes and 12 cases had no malignant LN involvement. There was no significant difference between both in S/L ratio, T2WISI (p < 0.140 & p = 0.079, respectively), while statistically significant difference between benign and malignant lymph nodes in both DWI and ADC mean values (p < 0.0001 & p < 0.007, respectively). The optimal ADC cut off value was ⩽.8 × 10−3 mm2/s for differentiation between benign and malignant lymph nodes with accuracy 96.7%, sensitivity 100%, specificity 87%, PPV 95.4% and NPV 100%.
Conclusion: Compared with lymph node size or routine magnetic resonance sequences, DWI and ADC are promising techniques for differentiating metastatic and non metastatic axillary lymph nodes in known breast cancer patients.
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