Open AccessCombined application of pharamcokinetic DCE‐MRI and IVIM‐DWI could improve detection efficiency in early diagnosis of ductal carcinoma in situ
Author(s) -
Tao Weijing,
Zhang Huixin,
Zhang Lianmei,
Gao Feng,
Huang Wei,
Liu Yan,
Zhu Yan,
Bai Genji
Publication year - 2019
Publication title -
journal of applied clinical medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.83
H-Index - 48
ISSN - 1526-9914
DOI - 10.1002/acm2.12624
Subject(s) - intravoxel incoherent motion , ductal carcinoma , in situ , medicine , radiology , carcinoma , medical physics , nuclear medicine , magnetic resonance imaging , diffusion mri , pathology , cancer , chemistry , breast cancer , organic chemistry
Purpose Ductal carcinoma in situ (DCIS) is a precursor of invasive ductal breast carcinoma (IDC). This study aimed to use pharamcokinetic dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) and intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI) for the early diagnosis of DCIS. Methods Forty‐seven patients, including 25 with DCIS (age: 28–70 yr, mean age: 48.7 yr) and 22 with benign disease (age: 25–67 yr, mean age: 43.1 yr) confirmed by pathology, underwent pharamcokinetic DCE‐MRI and IVIM‐DWI in this study. The quantitative parameters K trans , K ep , V e , V p , and D , f , D* were obtained by processing of DCE‐MRI and IVIM‐DWI images with Omni‐Kinetics and MITK‐Diffusion softwares, respectively. Parameters were analyzed statistically using GraphPad Prism and MedCalc softwares. Results All low‐grade DCIS lesions demonstrated mass enhancement with clear boundaries, while most middle‐grade and high‐grade DCIS lesions showed non‐mass‐like enhancement (NMLE). DCIS lesions were significantly different from benign lesions in terms of K trans , K ep , and D ( t = 5.959, P < 0.0001; t = 5.679, P < 0.0001; and t = 5.629, P < 0.0001, respectively). The AUC of K trans , K ep , D and the combined indicator of K trans , K ep, and D were 0.936, 0.902, 0.860, and 0.976, respectively. There was a significant difference in diagnostic efficacy only between D and the combined indicator ( Z = 2.408, P = 0.016). Conclusion DCE‐MRI and IVIM‐DWI could make for the early diagnosis of DCIS, and reduce the misdiagnosis of DCIS and over‐treatment of benign lesions.