The Effectiveness of 1.5 Tesla MRI in Predicting Axillary Lymph Node Metastasis in Cancer Patients with Breast-conserving Surgery
Abstract
Objective: Assessing axillary lymph node metastasis accurately before breast-conserving surgery is essential for guiding surgical decisions and improving diagnostic performance. The study aimed to determine the accuracy of breast magnetic resonance imaging (MRI) in assessing axillary lymph node metastasis in cancer patients undergoing breast-conserving surgery.
Material and Methods: A cross-sectional descriptive study was conducted on 76 breast cancer patients with indications for conservative surgery at the Vietnam National Cancer Hospital from June 2020 to May 2021. Patients were assessed for axillary lymph node metastasis using a 1.5 Tesla MRI machine through analysis of parameters of size and morphology on conventional sequences and Diffusion-Weighted Imaging (DWI) sequences. Data were analysed by descriptive statistics and T-test with IBM Statistical Package for the Social Sciences (SPSS) 25.0 software.
Results: Short-axis length, short/long axis ratio, cortical thickness, loss of fatty hilum, and eccentric cortical thickening were the parameters with statistically significant differences between the two groups of metastatic and non-metastatic lymph nodes (p-value-value<0.05). The Apparent diffusion coefficient (ADC) index was statistically significant between the two groups, with area under the curve (AUC) values higher than the AUC values of the parameters on conventional magnetic resonance (AUC: 0.874, with the optimal threshold of 1.046x10-3 mm2/s for sensitivity of 78.6%, specificity of 85.5%) (p-value<0.05).
Conclusion: Conventional MRI combined with DWI sequences can assess axillary lymph node metastasis in patients undergoing breast-conserving surgery with high sensitivity and specificity. Therefore, to improve treatment quality, it is necessary to assess axillary lymph node metastasis before breast-conserving surgery.
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