Dejing Ma1, Feng Lu2, Xuexue Zou3, Hu Zhang3, Yangyang Li4, Lin Zhang3, Liang Chen3, Dongjing Qin3, Bin Wang5. 1. Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, 250021, China; Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China. 2. Respiratory department, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China. 3. Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China. 4. Department of Pathology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China. 5. Medical Imaging Research Institute, Binzhou Medical University, Yantai, Shandong, 264003, China. Electronic address: binwang001@aliyun.com.
Abstract
PURPOSE: To investigate the value of use of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) as an adjunct to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to distinguish benign from malignant breast lesions. MATERIALS AND METHODS: Retrospective analysis of data pertaining to 117 patients with breast lesions who underwent DCE-MRI and IVIM-DWI examination with 3.0T MRI was conducted. A total of 128 lesions were pathologically confirmed (47 benign and 81 malignant). Between-group differences in DCE-MRI parameters (Morphology, enhancement pattern, maximum slope of increase (MSI) and time-signal curve (TIC) type) and IVIM-DWI parameters (f value, D value and D* value) were assessed. Multivariate logistic regression was performed to identify variables that distinguished benign from malignant breast lesions. The diagnostic performance of DCE-MRI and DCE-MRI plus IVIM-DWI, to distinguish benign from malignant breast lesions, was evaluated using pathology results as the gold standard. RESULTS: Lesion morphology, MSI, and TIC type (P<0.05), but not the enhancement pattern (P>0.05), were significantly different between the benign and malignant groups. The f (8.53±2.14) and D* (7.64±2.07) values in the malignant group were significantly higher than those in the benign group (7.68±1.97 and 6.83±2.13, respectively), while the D value (0.99±0.22) was significantly lower than that (1.34±0.17) in the benign group (P<0.05 for all). On logistic regression analysis, the sensitivity, specificity and accuracy of DCE-MRI were 90.1%, 70.2% and 82.8% respectively; the corresponding figures for the combination of IVIM-DWI and DCE-MRI were 88.8%, 85.1%, and 87.5%respectively. CONCLUSION: IVIM-DWI method as an adjunct to DCE-MRI can improve the specificity and accuracy in differential diagnosis of benign and malignant lesions of breast.
PURPOSE: To investigate the value of use of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) as an adjunct to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to distinguish benign from malignant breast lesions. MATERIALS AND METHODS: Retrospective analysis of data pertaining to 117 patients with breast lesions who underwent DCE-MRI and IVIM-DWI examination with 3.0T MRI was conducted. A total of 128 lesions were pathologically confirmed (47 benign and 81 malignant). Between-group differences in DCE-MRI parameters (Morphology, enhancement pattern, maximum slope of increase (MSI) and time-signal curve (TIC) type) and IVIM-DWI parameters (f value, D value and D* value) were assessed. Multivariate logistic regression was performed to identify variables that distinguished benign from malignant breast lesions. The diagnostic performance of DCE-MRI and DCE-MRI plus IVIM-DWI, to distinguish benign from malignant breast lesions, was evaluated using pathology results as the gold standard. RESULTS: Lesion morphology, MSI, and TIC type (P<0.05), but not the enhancement pattern (P>0.05), were significantly different between the benign and malignant groups. The f (8.53±2.14) and D* (7.64±2.07) values in the malignant group were significantly higher than those in the benign group (7.68±1.97 and 6.83±2.13, respectively), while the D value (0.99±0.22) was significantly lower than that (1.34±0.17) in the benign group (P<0.05 for all). On logistic regression analysis, the sensitivity, specificity and accuracy of DCE-MRI were 90.1%, 70.2% and 82.8% respectively; the corresponding figures for the combination of IVIM-DWI and DCE-MRI were 88.8%, 85.1%, and 87.5%respectively. CONCLUSION: IVIM-DWI method as an adjunct to DCE-MRI can improve the specificity and accuracy in differential diagnosis of benign and malignant lesions of breast.
Authors: Gene Y Cho; Lucas Gennaro; Elizabeth J Sutton; Emily C Zabor; Zhigang Zhang; Dilip Giri; Linda Moy; Daniel K Sodickson; Elizabeth A Morris; Eric E Sigmund; Sunitha B Thakur Journal: Eur J Radiol Open Date: 2017-08-18