Original Research

Differentiation of breast tuberculosis and breast cancer using diffusion-weighted, T2-weighted and dynamic contrast-enhanced magnetic resonance imaging

Dibuseng P. Ramaema, Richard J. Hift
South African Journal of Radiology | Vol 22, No 2 | a1377 | DOI: https://doi.org/10.4102/sajr.v22i2.1377 | © 2018 Dibuseng P. Ramaema, Richard J. Hift | This work is licensed under CC Attribution 4.0
Submitted: 16 June 2018 | Published: 25 October 2018

About the author(s)

Dibuseng P. Ramaema, Division of Radiation Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa
Richard J. Hift, Division of Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa


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Abstract

Background: The use of multi-parametric magnetic resonance imaging (MRI) in the evaluation of breast tuberculosis (BTB).

Objectives: To evaluate the value of diffusion-weighted imaging (DWI), T2-weighted (T2W) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating breast cancer (BCA) from BTB.

Method: We retrospectively studied images of 17 patients with BCA who had undergone preoperative MRI and 6 patients with pathologically proven BTB who underwent DCE-MRI during January 2014 to January 2015.

Results: All patients were female, with the age range of BTB patients being 23–43 years and the BCA patients being 31–74 years. Breast cancer patients had a statistically significant lower mean apparent diffusion coefficient (ADC) value (1072.10 +/- 365.14), compared to the BTB group (1690.77 +/- 624.05, p = 0.006). The mean T2-weighted signal intensity (T2SI) was lower for the BCA group (521.56 +/- 233.73) than the BTB group (787.74 +/- 196.04, p = 0.020). An ADC mean cut-off value of 1558.79 yielded 66% sensitivity and 94% specificity, whilst the T2SI cut-off value of 790.20 yielded 83% sensitivity and 83% specificity for differentiating between BTB and BCA. The homogeneous internal enhancement for focal mass was seen in BCA patients only.

Conclusion: Multi-parametric MRI incorporating the DWI, T2W and DCE-MRI may be a useful tool to differentiate BCA from BTB.


Keywords

breast cancer; breast tuberculosis; diffusion weighted imaging; magnetic resonance imaging

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