Histogram analysis of volume-based apparent diffusion coefficient in breast cancer

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Breast cancer is a heterogeneous disease with varying aggressiveness and prognosis.
• Apparent diffusion coefficient (ADC) values from MRI show associations with tumor characteristics.

Purpose of the Study:

• To evaluate histogram analysis of whole-tumor-volume ADC values for differentiating breast cancer subtypes.
• Specifically comparing ductal carcinoma in situ (DCIS), invasive ductal cancer with DCIS components (IDC-DCIS), and pure invasive ductal cancer (IDC).

Main Methods:

• Retrospective study of 201 patients with confirmed DCIS or IDC.
• Preoperative 3.0T breast MRI with diffusion-weighted imaging.
• Calculation and statistical analysis of histogram parameters (ADC values, skewness, kurtosis).

Main Results:

• Significant differences in ADC value percentiles were observed between DCIS, IDC-DCIS, and pure IDC groups.
• ADC50 was the best discriminator between IDC and DCIS (threshold 1.185 × 10⁻³ mm²/s; sensitivity 82.9%, specificity 75.7%).
• Multivariate analysis revealed no significant differences in ADC values for differentiating these subtypes (P > 0.05).

Conclusions:

• Volume-based ADC values correlate with breast cancer heterogeneity.
• Histogram analysis of ADC values did not provide additional diagnostic performance for differentiating DCIS, IDC-DCIS, and pure IDC.