Abstract

Background: Breast cancer is the most common woman cancer. Accurate diagnosis of metastatic axillary lymph node (ALN) have an important role because it controls the clinical therapeutic schedule and influence overall disease prognosis.

The development of MRI including DWI\ADC sequences improve the detection of axillary lymph nodes metastasis using the Brownian phenomena this represents an important non-invasive method with no need for contrast media.

Aim of this study: To evaluate the role of the apparent diffusion coefficient in

the differentiation between metastatic and benign non metastatic axillary lymph

nodes .

Patients and methods: A prospective cohort study was conducted at

Oncology teaching hospital in Medical city teaching compass during a period of

10 months between January 2022 until November 2022.

Our study includes 58 women. MRI was performed using a 1.5 Tesla MRI using a dedicated bilateral sixteen channel breast coils. The mean ADC value were measured for axillary lymph nodes and results were compared with histopathological findings.

The optimal ADC cut off values were evaluated using receiver coefficient

characteristic (ROC) curves.

Results: The histopathological examination reveals that 37.9% of examined

lymph nodes were metastatic and 62.1% was non-metastatic.

The ADC value of the metastatic ALN was significantly lower than that of the

non-metastatic ALN (0.78 x10–3 mm2/s vs 2.39 x10–3 mm2/s, P= 0.009).

The optimal cut-off ADC value for the discrimination between metastatic and

non-metastatic lymph-nodes was 0.97x10–3mm2/s with sensitivity and specificity

of 95.5% and 100% respectively, and accuracy of 98.3%. Positive predictive

value and negative predictive value of ADC were 100% and 97.3% respectively.

Conclusion: The ADC value obtain important role in prediction of axillary

lymph nodes metastasis with a diagnostic accuracy of 98.3% in this study.

Key Words: Breast cancer, axillary lymph nodes, magnetic resonance imaging,

apparent diffusion coefficient.