Ann Yi MD, Presenter: Nothing to Disclose

Bo Kyoung Seo MD, PhD, Abstract Co-Author: Nothing to Disclose

Kyu Ran Cho MD, Abstract Co-Author: Nothing to Disclose

Ok Hee Woo MD, Abstract Co-Author: Nothing to Disclose

Kyu Won Hwang, Abstract Co-Author: Nothing to Disclose

Sang Hoon Cha MD, Abstract Co-Author: Nothing to Disclose

To evaluate the usefulness of color mapping images on MR CAD system with 3 tesla MR imaging in differentiation metastatic axillary lymph node from benign axillary lymph node.

MR CAD color mapping images of 31 patients with breast cancer(8 cancers with surgically proven axillary lymph node(LN) metastasis and 23 cancers without LN metastasis) were retrospectively reviewed. Patients who received a preoperative chemotherapy or an endocrine therapy were excluded. We confirmed to be a LN by comparing contrast-enhanced fat-supressed T1-weighted coronal images(CE-FS-coronal T1WI) to avoid to regard blood vessel as a LN. When we could detect a axillary LN with internal color on MR CAD color mapping images, we classified them into 4 groups such as dorminently red(washout), dorminently yellow(plateau), dorminently blue(persistent), and mixed patterns. In addition, when we could not detect a axillary LN on CE-FS-T1WI or absence of color within a LN on color mapping images, we regarded as a negative group. Thereafter, these 5 groups were correlated with surgical pathology and the size of axillary LNs as well as pathology of primary breast malignancy.

Axillary LNs were detected as an internal color mapping on MR CAD images in 25 cancers including 8 cases with metastasis(32%) and 17 cases without metastasis(68%). All of 6 axillary LNs(100%) of negative group on MR CAD color mapping images were surgically confirmed to no metastasis. Among the 8 cases of surgically confirmed metastasis, 7 cases(88%) were dorminently red on MR CAD color mapping images. Dorminently red color mapping had statistically significant difference between metastasis and no metastasis(P=0.017 on logistic regression). However, the size of axillary LN and pathology of breast malignancy(invasive cancer vs ductal carcinoma in situ) had not statistically significant difference between metastasis and no metastasis(P=0.131 on logistic regression and P=0.068 on Fisher's extraction test).

Axillary LN with dorminently red(washout) color mapping in on MR CAD images may suggest the possibility of metastasis without relation of their size. Therefore, MR CAD color mapping images may provide a significant diagnostic clue in axillary LN metastasis as well as in primary breast cancer.  

MR CAD color mapping images may provide a significant diagnostic clue in axillary LN metastasis as well as in primary breast cancer.

Yi, A, Seo, B, Cho, K, Woo, O, Hwang, K, Cha, S, Breast MR CAD (Computer-assisted Diagnosis) System with 3 Tesla Magnet of Axillary Lymph Nodes in Patients of Breast Cancer: Red Is Metastasis?  .  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010398.html