Abstract:

Aim: The prognostic value of apparent diffusion coefficient (ADC) measurement to detect axillary malignant lymph nodes in breast cancer is not clear. We aimed to investigate the prognostic importance of diffusion weighted imaging (DWI) in the differentiation of metastatic and non-metastatic lymph nodes. Methods: Magnetic resonance imagings (MRIs) of 102 breast cancer patients were reviewed from the hospital PACS and automation systems between July 2018 and March 2021. Cortical thickness, short, long-axis diameters, long/short axis ratios and ADC measurements were done for ipsilateral and contralateral axillary lymph nodes. Univariate and multivariate regression analyses were performed. Results: Pathology revealed that 64 patients had ipsilateral metastatic lymph nodes while 38 patients did not. When grouped into metastatic and non-metastatic groups, breast tumor size, mean diameter of the short axis, long axis and cortical thickness were significantly higher in the metastatic group. Ipsilateral metastatic lymph nodes’ mean ADC values were significantly lower than non-metastatic ones with a calculated value of 0.972x10-3. The ipsilateral ADC value of the lymph node and loss of fatty hilum were the two significant factors to predict metastatic lymph nodes in multivariate analysis. Conclusion: DWI is a valuable noninvasive tool in the diagnosis of metastatic axillary lymph nodes.

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