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DWI or dynamic contrast-enhanced curve: a retrospective analysis of MRI-based differential diagnosis of benign and malignant breast lesions
Xiaoping Yang1, Lina Zhang1, Shu Li1, Ruimei Chai1, Zheng Zhang1, Nan Li1, and Mengshi Dong1
1Department of Radiology, the First Affiliated Hospital of China Medical University, Shenyang, China

Synopsis

Combined with morphological and enhanced information, DWI model is superior or equal to TIC model in differentiating benign and malignant breast lesions.

Abstract

Objective To compare the diagnostic performance of models based on diffusion-weighted imaging (DWI) or time-intensity curves (TICs) in distinguishing benign and malignant breast lesions. Methods A double-blind retrospective study was conducted in 254 patients (286 suspicious lesions) who underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast and obtained pathological results. Univariate binary logistic regression was applied for the apparent diffusion coefficient (ADC) value and dynamic enhancement curve (TIC) for diagnosis of benign and malignant lesions. The DWI model (ADC value + morphology + enhanced information) and the TIC model (TIC + morphology + enhanced information) were established with binary logistic regression for mass lesions and non-mass lesions respectively. The sensitivity, specificity and area under curve (AUC) were compared. The receiver operating characteristic (ROC) curves were calculated. P < 0.05 showed statistical difference. Results The sensitivities, specificities and AUC of ADC value/ TIC were 80.82%/96.80%, 77.61%/25.37% and 0.831/0.692, respectively. AUC showed significant difference between these two groups (P < 0.05). For masses, the AUC was 0.914 in DWI model and 0.868 in TIC model, with significant difference (P < 0.05). For NMEs, the AUC showed no significant difference between the DWI model and the TIC model. Conclusions Combined with morphological and enhanced information, DWI model is superior or equal to TIC model in differentiating benign and malignant breast lesions.

Acknowledgements

No acknowledgement found.

References

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Figures

Fig.1 A 49-year-old female patient with a invasive lobular carcinoma in the left breast. A) Enhanced T1WI shows a irregular mass with spiculated margin and homogeneous internal enhancement; B) the time-signal intensity curve was at a plateau phase; C) the DWI image shows a hyperintense mass; D) the measured ADC value was 0.752×10-3 mm2/s. The curve model scored 3 and the diffusion model scored 3, and the lesion was correctly diagnosed as malignant.

Fig.2 A 39-year-old female patient with invasive ductal carcinoma of the left breast. A) Enhanced T1WI shows a round mass with irregular margin and heterogeneous internal enhancement; B) the time-signal intensity curve was at a washout phase; C) the DWI image shows a hyperintense mass; D) the measured ADC value was about 0.928×10-3 mm2/s. The curve model scored 5 and the diffusion model scored 4, and the lesion was correctly diagnosed as malignant.

Fig.3 ROC curves for predicting benign and malignant breast lesions in logistic regression models of diffusion and curves for masses

Proc. Intl. Soc. Mag. Reson. Med. 28 (2020)
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