Skip to content


Cancer Imaging

Open Access

Three-dimensionally fused gadolinium-enhanced and diffusion-weighted images: value in determination of multi-centricity of breast carcinoma

Cancer Imaging201414(Suppl 1):S8

Published: 9 October 2014


72 patients with biopsy-proven breast carcinoma were sent to MR imaging for preoperative assessment of multicentricity. Based on mastectomy/ lumpectomy specimens and further biopsies, 47 patients had single lesions, and 25 had multiple lesions with a total number of 116 proven malignant foci. The preoperative MR images were retrospectively reviewed and post-processed to obtain three-dimensional fused images of early gadolinium enhancement (encoded in red) and diffusion-weighted images (encoded in green) at b=1500 s/mm2. To eliminate the T2 shine-through effect, lesions with ADC ≥ 1× 10−3 mm 2 /s were eliminated. The post-processed images were reviewed by an experienced blinded radiologist, who noted all the lesions with a diameter ≥ 5 mm, classifying them into three groups: matched enhancement and diffusion restriction (matched E-DR), unmatched diffusion restriction (DR), and unmatched enhancement (E).


313 lesions with a diameter ≥ 5 mm were identified. 101 lesions showed matched E-DR. Taking matched E-DR as indicative of malignancy, sensitivity, specificity, positive predictive value, negative predictive value and accuracy for diagnosis of individual malignant foci were 84.5, 98.5, 97, 91, and 93.3 % respectively. Three false positive foci of matched E-DR were due to fibroadenomas. 18 false negative foci have been due to foci of DCIS less than 1 cm in diameter. Conclusion: Fused images of gadolinium enhancement and diffusion restriction offer a reasonably accurate assessment of multicentricity in patients with breast carcinoma.

Authors’ Affiliations

Hamad Medical Corporation, Doha, Qatar


© Sherif et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.