Intravoxel 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 |
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| Institution: | 1. Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, 250021, China;2. Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China;3. Respiratory department, 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;1. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China;2. Department of Radiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, P.R. China;3. Department of Radiology, The Third Hospital of Xuzhou City, Xuzhou, P.R. China;1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland;2. Institute for Surgical Pathology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland |
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| Abstract: | PurposeTo 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 methodsRetrospective analysis of data pertaining to 117 patients with breast lesions who underwent DCE-MRI and IVIM-DWI examination with 3.0 T 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.ResultsLesion 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.ConclusionIVIM-DWI method as an adjunct to DCE-MRI can improve the specificity and accuracy in differential diagnosis of benign and malignant lesions of breast. |
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