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Quantitative differentiation of breast lesions at 3T diffusion‐weighted imaging (DWI) using the ratio of distributed diffusion coefficient (DDC)
Author(s) -
Ertas Gokhan,
Onaygil Can,
Akin Yasin,
Kaya Handan,
Aribal Erkin
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25327
Subject(s) - effective diffusion coefficient , diffusion mri , diffusion , medicine , nuclear medicine , magnetic resonance imaging , coefficient of variation , nuclear magnetic resonance , radiology , chemistry , physics , chromatography , thermodynamics
Purpose To investigate the accuracy of diffusion coefficients and diffusion coefficient ratios of breast lesions and of glandular breast tissue from mono‐ and stretched‐exponential models for quantitative diagnosis in diffusion‐weighted magnetic resonance imaging (MRI). Materials and Methods We analyzed pathologically confirmed 170 lesions (85 benign and 85 malignant) imaged using a 3.0T MR scanner. Small regions of interest (ROIs) focusing on the highest signal intensity for lesions and also for glandular tissue of contralateral breast were obtained. Apparent diffusion coefficient (ADC) and distributed diffusion coefficient (DDC) were estimated by performing nonlinear fittings using mono‐ and stretched‐exponential models, respectively. Coefficient ratios were calculated by dividing the lesion coefficient by the glandular tissue coefficient. Results A stretched exponential model provides significantly better fits then the monoexponential model ( P < 0.001): 65% of the better fits for glandular tissue and 71% of the better fits for lesion. High correlation was found in diffusion coefficients (0.99–0.81 and coefficient ratios (0.94) between the models. The highest diagnostic accuracy was found by the DDC ratio (area under the curve [AUC] = 0.93) when compared with lesion DDC, ADC ratio, and lesion ADC (AUC = 0.91, 0.90, 0.90) but with no statistically significant difference ( P > 0.05). At optimal thresholds, the DDC ratio achieves 93% sensitivity, 80% specificity, and 87% overall diagnostic accuracy, while ADC ratio leads to 89% sensitivity, 78% specificity, and 83% overall diagnostic accuracy. Conclusion The stretched exponential model fits better with signal intensity measurements from both lesion and glandular tissue ROIs. Although the DDC ratio estimated by using the model shows a higher diagnostic accuracy than the ADC ratio, lesion DDC, and ADC, it is not statistically significant. J. Magn. Reson. Imaging 2016;44:1633–1641.