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Application of whole‐lesion histogram analysis of pharmacokinetic parameters in dynamic contrast‐enhanced MRI of breast lesions with the CAIPIRINHA‐Dixon‐TWIST‐VIBE technique
Author(s) -
Li Zhiwei,
Ai Tao,
Hu Yiqi,
Yan Xu,
Nickel Marcel Dominik,
Xu Xiao,
Xia Liming
Publication year - 2018
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.25762
Subject(s) - percentile , kurtosis , medicine , receiver operating characteristic , nuclear medicine , magnetic resonance imaging , breast mri , dynamic contrast , radiology , skewness , dynamic contrast enhanced mri , biopsy , lesion , pathology , mathematics , breast cancer , mammography , statistics , cancer
Purpose To investigate the application of whole‐lesion histogram analysis of pharmacokinetic parameters for differentiating malignant from benign breast lesions on dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI). Materials and Methods In all, 92 women with 97 breast lesions (26 benign and 71 malignant lesions) were enrolled in this study. Patients underwent dynamic breast MRI at 3T using a prototypical CAIPIRINHA‐Dixon‐TWIST‐VIBE (CDT‐VIBE) sequence and a subsequent surgery or biopsy. Inflow rate of the agent between plasma and interstitium ( K trans ), outflow rate of agent between interstitium and plasma ( K ep ), extravascular space volume per unit volume of tissue ( v e ) including mean value, 25th/50th/75th/90th percentiles, skewness, and kurtosis were then calculated based on the whole lesion. A single‐sample Kolmogorov–Smirnov test, paired t ‐test, and receiver operating characteristic curve (ROC) analysis were used for statistical analysis. Results Malignant breast lesions had significantly higher K trans , K ep , and lower v e in mean values, 25th/50th/75th/90th percentiles, and significantly higher skewness of v e than benign breast lesions (all P < 0.05). There was no significant difference in kurtosis values between malignant and benign breast lesions (all P > 0.05). The 90th percentile of K trans , the 90th percentile of K ep , and the 50th percentile of v e showed the greatest areas under the ROC curve (AUC) for each pharmacokinetic parameter derived from DCE‐MRI. The 90th percentile of K ep achieved the highest AUC value (0.927) among all histogram‐derived values. Conclusion The whole‐lesion histogram analysis of pharmacokinetic parameters can improve the diagnostic accuracy of breast DCE‐MRI with the CDT‐VIBE technique. The 90th percentile of K ep may be the best indicator in differentiation between malignant and benign breast lesions. Level of Evidence: 4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2018;47:91–96.