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Use of diffusion kurtosis imaging and quantitative dynamic contrast‐enhanced MRI for the differentiation of breast tumors
Author(s) -
Li Ting,
Yu Tao,
Li Lyu,
Lu Lunbo,
Zhuo Yaoyao,
Lian Jingge,
Xiong Yun,
Kong Dexing,
Li Kangan
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.26059
Subject(s) - medicine , effective diffusion coefficient , kurtosis , diffusion mri , breast cancer , receiver operating characteristic , breast mri , dynamic contrast , nuclear medicine , dynamic contrast enhanced mri , magnetic resonance imaging , radiology , cancer , mammography , mathematics , statistics
Background Breast MRI is a sensitive imaging technique to assess breast cancer but its effectiveness still remains to be improved. Purpose To evaluate the diagnostic performance of diffusion‐weighted imaging (DWI), diffusion kurtosis imaging (DKI), and quantitative dynamic contrast‐enhanced (DCE)‐MRI in differentiating malignant from benign breast lesions independently or jointly and to explore whether correlations exist among these parameters. Study Type Retrospective. Population In all, 106 patients with breast lesions (47 malignant, 59 benign). Sequence DKI sequence with seven b values and quantitative DCE sequence on 3.0T MRI. Assessment Diffusion parameters (mean diffusivity [MD], mean diffusivity [MK], and apparent diffusion coefficient [ADC]) from DKI and DWI and perfusion parameters from DCE (K trans , k ep , v e , and v p ) were calculated by two experienced radiologists after postprocessing. Disagreement between the two observers was resolved by consensus. Statistical Tests The parameters in benign and malignant lesions were compared by Student's t ‐test. The diagnostic performances of DKI and quantitative DCE, either alone or in combination, were evaluated by receiver operating characteristic (ROC) analysis. The Spearman correlation test was used to evaluate correlations among the diffusion parameters and perfusion parameters. Results MK, MD, ADC, K trans , and k ep values were significantly different between breast cancer and benign lesions ( P < 0.05). MK from DKI demonstrated the highest AUC of 0.849, which is significantly higher than ADC derived from conventional DWI (z = 3.345, P = 0.0008). The specificity of DCE‐MRI‐derived parameters was improved when combining diffusion parameters, such as ADC and MK. The highest diagnostic specificity (93.2%) was obtained when k ep and ADC were combined. k ep was correlated moderately positively with MK ( r = 0.516) and moderately negatively with MD ( r = –0.527). K trans was weakly positively correlated with MK with an r of 0.398 and weakly negatively correlated with MD with an r of –0.450. Data Conclusion DKI is more valuable than conventional DWI in distinguishing between benign and malignant breast lesions. DKI exhibits promise as a quantitative technique to augment quantitative DCE‐MRI. Diffusion parameters derived from DKI were statistically correlated with perfusion parameters from quantitative DCE‐MRI. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1358–1366.