In order to comparethe diagnosis efficiency of different parameters derived from diffusion kurtosis imaging model in benign and malignant breast lesions, eighty patients were analyzed in this study . DKI data with six b-values and 15 directions were acquired using single-shot SE-EPI sequence. The values of mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis(RK) in malignant lesions group were significantly higher than those in benign lesions groups. The diagnosis efficiency of these parameters were also analyzed. The results showed that DKI-derived parameters can be used to distinguish the malignant lesions and benign lesions, especially AK and MK
METHODS:
A prospective study was reviewed by the ethics committee of the hospital. All recruited patients signed written informed consent. Ninety-six patients with breast lesions were recruited in this study, but sixteen patients were lost to follow up. Finally, eighty lesions in eighty patients (age range 17-65 years,42±1.4 years) were examined on 3.0T GE Discovery 750 with 8 channel bilateral breast coil. DKI data was acquired for 10 minutes 48 seconds using single-shot spin-echo pulse sequence (TR/TE-4015s/minimum, thickness 4mm, space 1mm, Matrix-256×256, FOV-32cm×32cm, six b-values 0,500,1000,1500,2000,2500s/mm2, 15 directions, NEX 2).Breast lesions were divided into two groups according to pathological characteristics. DKI-related parameters, MK, AK and RK, were measured after scanning. Acquired MR images were analyzed by two radiologists with over 5 years of experience in the diagnosis of breast lesions. Regions of interest (ROIs)significantly enhanced in the lesion were selected, except areas of cystic degeneration and necrosis. The parameters MK,AK and RK of malignant and benign lesions were compared by Mann-Whitney U tests. Receiver operation curve (ROC) analysis was performed to assess the sensitivity and specificity of MK,AK and RK in the diagnosis of breast lesions.RESULTS:
The values of MK,AK and RK in malignant lesions group were significantly higher than those in benign lesions groups (shown in Table 1).In addition, the current results showed that the sensitivity /specificity of these three parameters in the diagnosis of malignant were 77.8% /63.6%,75%/81.8%and 72.2%/63.6%.Respectively, the area under the curve of parameters MK, AK and RK were 0.728,0.782and 0.688 (shown in Figure 1).Figure 2and 3 showed the parameters images of two typical patients.CONCLUSIONS:
Our results showed that DKI-derived parameters could be used to distinguish the malignant lesions and benign lesions, especially AK and MK. Both of these two parameters had considerable sensitivity. Furthermore, AK had the highest specificity among all the diffusion kurtosis related parameters. This study demonstrates that AK and MK have the potential to be used as a biomarker in the diagnostic of breast lesions clinically.1. Ma D, Lu F, Zou XIntravoxel incoherent motion diffusion-weighted imaging as an adjunct to dynamic contrast-enhanced MRI to improve accuracy of the differential diagnosis of benign and malignant breast lesions. Magn Reson Imaging.( 2016) Oct 11. Pii : S0730-725X(16)30152-7
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Table 1 Comparison different diffusion variables between the two pathology types