Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes

Alison Dorothy Murray, Roger T Staff, Fiona Jane Gilbert, Iain D Miller, S. Payne, Thomas William Redpath, A. K. Ah-See, J. A. Brookes

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Axillary lymph node status is the most important prognostic factor in breast cancer patients and is currently determined by surgical dissection. This study was performed to assess whether dynamic gadopentetate dimeglumine (Gd) enhanced MRI is an accurate method for noninvasive staging of the axilla. 47 women with a new primary breast cancer underwent preoperative dynamic Gd enhanced MRI of the ipsilateral axilla. Lymph node enhancement was quantitatively analysed using a region of interest method. Enhancement indices and nodal area were compared with histopathology of excised nodes using a receiver operating characteristic (ROC) curve approach. 10 patients had axillary metastases pathologically and all had greater than or equal to 1 lymph node with an enhancement index of >21% and a nodal area of >0.4 cm(2). 37 patients had negative axillary nodes pathologically. 20 of these had enhancement indices <21% and nodal areas <0.4 cm(2). Using this method, a sensitivity of 100%, a specificity of 56%, a positive predictive value of 38% and a negative predictive value of 100% could be achieved. Using this method of quantitative assessment, dynamic Gd enhanced MRI may be a reliable method of predicting absence of axillary nodal metastases in women with breast cancer, thereby avoiding axillary surgery in women with a negative MRI study.

Original languageEnglish
Pages (from-to)220-228
Number of pages8
JournalBritish Journal of Radiology
Volume75
Issue number891
Publication statusPublished - 2002

Keywords

  • MAGNETIC-RESONANCE MAMMOGRAPHY
  • LYMPH-NODE
  • PROGNOSTIC-SIGNIFICANCE
  • PREOPERATIVE DETECTION
  • MICRO-METASTESES
  • METASTASES
  • CARCINOMA
  • DISSECTION
  • MACROMETASTASES
  • EXPERIENCE

Cite this

Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes. / Murray, Alison Dorothy; Staff, Roger T; Gilbert, Fiona Jane; Miller, Iain D; Payne, S.; Redpath, Thomas William; Ah-See, A. K.; Brookes, J. A.

In: British Journal of Radiology, Vol. 75, No. 891, 2002, p. 220-228.

Research output: Contribution to journalArticle

@article{19b3223151e94d418870886aa65d8203,
title = "Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes",
abstract = "Axillary lymph node status is the most important prognostic factor in breast cancer patients and is currently determined by surgical dissection. This study was performed to assess whether dynamic gadopentetate dimeglumine (Gd) enhanced MRI is an accurate method for noninvasive staging of the axilla. 47 women with a new primary breast cancer underwent preoperative dynamic Gd enhanced MRI of the ipsilateral axilla. Lymph node enhancement was quantitatively analysed using a region of interest method. Enhancement indices and nodal area were compared with histopathology of excised nodes using a receiver operating characteristic (ROC) curve approach. 10 patients had axillary metastases pathologically and all had greater than or equal to 1 lymph node with an enhancement index of >21{\%} and a nodal area of >0.4 cm(2). 37 patients had negative axillary nodes pathologically. 20 of these had enhancement indices <21{\%} and nodal areas <0.4 cm(2). Using this method, a sensitivity of 100{\%}, a specificity of 56{\%}, a positive predictive value of 38{\%} and a negative predictive value of 100{\%} could be achieved. Using this method of quantitative assessment, dynamic Gd enhanced MRI may be a reliable method of predicting absence of axillary nodal metastases in women with breast cancer, thereby avoiding axillary surgery in women with a negative MRI study.",
keywords = "MAGNETIC-RESONANCE MAMMOGRAPHY, LYMPH-NODE, PROGNOSTIC-SIGNIFICANCE, PREOPERATIVE DETECTION, MICRO-METASTESES, METASTASES, CARCINOMA, DISSECTION, MACROMETASTASES, EXPERIENCE",
author = "Murray, {Alison Dorothy} and Staff, {Roger T} and Gilbert, {Fiona Jane} and Miller, {Iain D} and S. Payne and Redpath, {Thomas William} and Ah-See, {A. K.} and Brookes, {J. A.}",
year = "2002",
language = "English",
volume = "75",
pages = "220--228",
journal = "British Journal of Radiology",
issn = "0007-1285",
publisher = "British Institute of Radiology",
number = "891",

}

TY - JOUR

T1 - Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes

AU - Murray, Alison Dorothy

AU - Staff, Roger T

AU - Gilbert, Fiona Jane

AU - Miller, Iain D

AU - Payne, S.

AU - Redpath, Thomas William

AU - Ah-See, A. K.

AU - Brookes, J. A.

PY - 2002

Y1 - 2002

N2 - Axillary lymph node status is the most important prognostic factor in breast cancer patients and is currently determined by surgical dissection. This study was performed to assess whether dynamic gadopentetate dimeglumine (Gd) enhanced MRI is an accurate method for noninvasive staging of the axilla. 47 women with a new primary breast cancer underwent preoperative dynamic Gd enhanced MRI of the ipsilateral axilla. Lymph node enhancement was quantitatively analysed using a region of interest method. Enhancement indices and nodal area were compared with histopathology of excised nodes using a receiver operating characteristic (ROC) curve approach. 10 patients had axillary metastases pathologically and all had greater than or equal to 1 lymph node with an enhancement index of >21% and a nodal area of >0.4 cm(2). 37 patients had negative axillary nodes pathologically. 20 of these had enhancement indices <21% and nodal areas <0.4 cm(2). Using this method, a sensitivity of 100%, a specificity of 56%, a positive predictive value of 38% and a negative predictive value of 100% could be achieved. Using this method of quantitative assessment, dynamic Gd enhanced MRI may be a reliable method of predicting absence of axillary nodal metastases in women with breast cancer, thereby avoiding axillary surgery in women with a negative MRI study.

AB - Axillary lymph node status is the most important prognostic factor in breast cancer patients and is currently determined by surgical dissection. This study was performed to assess whether dynamic gadopentetate dimeglumine (Gd) enhanced MRI is an accurate method for noninvasive staging of the axilla. 47 women with a new primary breast cancer underwent preoperative dynamic Gd enhanced MRI of the ipsilateral axilla. Lymph node enhancement was quantitatively analysed using a region of interest method. Enhancement indices and nodal area were compared with histopathology of excised nodes using a receiver operating characteristic (ROC) curve approach. 10 patients had axillary metastases pathologically and all had greater than or equal to 1 lymph node with an enhancement index of >21% and a nodal area of >0.4 cm(2). 37 patients had negative axillary nodes pathologically. 20 of these had enhancement indices <21% and nodal areas <0.4 cm(2). Using this method, a sensitivity of 100%, a specificity of 56%, a positive predictive value of 38% and a negative predictive value of 100% could be achieved. Using this method of quantitative assessment, dynamic Gd enhanced MRI may be a reliable method of predicting absence of axillary nodal metastases in women with breast cancer, thereby avoiding axillary surgery in women with a negative MRI study.

KW - MAGNETIC-RESONANCE MAMMOGRAPHY

KW - LYMPH-NODE

KW - PROGNOSTIC-SIGNIFICANCE

KW - PREOPERATIVE DETECTION

KW - MICRO-METASTESES

KW - METASTASES

KW - CARCINOMA

KW - DISSECTION

KW - MACROMETASTASES

KW - EXPERIENCE

M3 - Article

VL - 75

SP - 220

EP - 228

JO - British Journal of Radiology

JF - British Journal of Radiology

SN - 0007-1285

IS - 891

ER -