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Effectivity and correlation of parameters derived from diffusion kurtosis imaging and quantitative dynamic contrast-enhanced MRI in the breast imaging
Ting Li1, Siying Wang2, Yun Xiong3, and Kangan Li1

1Shanghai General Hospital, Shanghai, China, 2PhilipsHealthcare, Shanghai, China, 3Fudan University, Shanghai, China

Synopsis

The aim of this study is to evaluate the diagnostic efficacy of 3.0T MRI diffusion kurtosis imaging and quantitative dynamic contrast enhancement in benign and malignant breast lesions, and to explore the differential diagnosis ability of different pathological types and molecular subtype lesions. The results showed that 3.0T MRI diffusion kurtosis imaging and dynamic contrast-enhanced quantitative hemodynamic parameters are of great value in the differential diagnosis of benign and malignant breast lesions. The combination of both can significantly improve the diagnostic efficiency.

Objective

To evaluate the diagnostic performance of diffusion kurtosis imaging (DKI), conventional diffusion-weighted imaging (DWI) and quantitative dynamic contrast-enhanced breast MRI (DCE-MRI) in differentiating malignant from benign breast lesions independently or jointly and to explore whether correlations exist among these parameters.

Methods

One hundred nine patients were included in the study. Quantitative parameters from DKI (MD, MK), DWI (ADC) and quantitative DCE-MRI (Ktrans, Kep, Ve and Vp) were calculated. Two blinded radiologists evaluated findings in consensus. The diagnostic performances of DKI, DWI and quantitative DCE-MRI, either alone or in combination, were statistically evaluated. The Spearman correlation test was used to evaluate correlations among the DKI-, DWI- and quantitative DCE-MRI-derived parameters.

Results

MK and MD from DKI and ADC from DWI and Ktrans and Kep from quantitative DCE-MRI were significantly different between breast cancer and benign lesions (p < 0.05, respectively). MK demonstrated the largest area under the receiver operating characteristic curve (AUC = 0.849) and had the highest specificity (83.1%) and accuracy (82.1%) with a cut-off value of 0.727, while Ktrans showed the highest sensitivity (91.5%) with a cut-off value of 0.067 min-1. The highest diagnostic specificity (93.2%) was obtained when ADC and Kep were combined. The highest accuracy (86.8%) and AUC (0.879) were attained when all of the parameters were combined. Kep was correlated moderately positively with MK (r = 0.516) and moderately negatively with MD (r = -0.527). Ktrans was weakly positively correlated with MK with an r of 0.398 and weakly negatively correlated with MD with an r of -0.450.

Conclusions

DKI-derived parameters can significantly improve diagnostic performance compared with the ADC from conventional DWI. DKI exhibits promise as a quantitative technique to augment quantitative DCE-MRI. The diagnosis was improved when the parameters were combined. Diffusion parameters derived from DKI were statistically correlated with parameters from quantitative DCE-MRI.

Acknowledgements

No acknowledgement found.

References

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Figures

Figure1: Box plots distribution of the parameters by lesion type using the conventional DWI(a) and DKI (b and c). (d)Graph shows receiver operating characteristic curves to assess independent or combined performance of the parameters for discriminating malignant and benign lesions.

Figure2: Box plots distribution of the parameters by lesion type using quantitative DCE-MRI(a-d).

Figure3: A 57-year-old woman with left breast invasive ductal carcinoma, Grade 3. (a) DWI with a b-value of 0 s/mm2 image shows a hyperintense lesion. The values for ADC, MK and MD are 1.090 mm2/s, 1.154 and 0.808 mm2/s, respectively(b-d).

Figure4: A 29-year-old woman with right breast fibroadenoma. (a-d) All perfusion images shown a hyperintense lesion. The values for Ktrans, Ve , Vp and Kep are 75.957min-1, 283.017, 14.060 and 279.001min-1, respectively.

Proc. Intl. Soc. Mag. Reson. Med. 26 (2018)
4461