Premium
Assessment of breast mass morphology with diffusion‐weighted MRI: Beyond apparent diffusion coefficient
Author(s) -
Kul Sibel,
Metin Yavuz,
Kul Musa,
Metin Nurgul,
Eyuboglu Ilker,
Ozdemir Oguzhan
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.26175
Subject(s) - medicine , breast mri , effective diffusion coefficient , radiology , diffusion mri , malignancy , kappa , cohen's kappa , nuclear medicine , bi rads , breast imaging , magnetic resonance imaging , breast cancer , mammography , pathology , cancer , linguistics , philosophy , machine learning , computer science
Background Diffusion‐weighted imaging (DWI) is a noncontrast‐enhanced MRI technique. There are new promising studies on the use of DWI as a part of the enhanced or unenhanced abbreviated breast MRI protocols. Purpose To evaluate the ability of breast DWI in the assessment of mass morphology and determine the contribution of this morphologic evaluation in their characterization. Study Type Retrospective. Population In all, 213 consecutive women were breast MR imaged and had a later confirmed diagnosis. Field Strength/Sequence Breast dynamic contrast‐enhanced‐MRI (DCE‐MRI) and DWI at 1.5T. Assessment After Institutional Review Board approval, two radiologists first independently, and later in consensus, evaluated the visibility and morphology of the 143 malignant, 70 benign masses on DWI and DCE‐MRI in separate sessions, blindly. Shape, margin, and internal pattern of the masses were evaluated according to BI‐RADS lexicon. Apparent diffusion coefficient (ADC) and tumor size were measured by one radiologist. Statistical Tests Consistency between imaging methods and readers was evaluated with Cohen's kappa statistics. Multivariate analysis was applied to find the best predictors of malignancy. Results Tumor visibility on DWI was high to moderate in at least 88% of cases. Consistency between DWI and DCE‐MRI was substantial (kappa ≥0.757) for shape and margin and moderate (kappa = 0.505) for internal pattern. Interobserver agreement was substantial to moderate for all morphologic parameters (kappa ≥0.596). Morphology evaluated on DWI provided 83–84% accuracy in discriminating malignant from benign masses. ADC alone provided 90–91% accuracy. Both morphologic parameters and ADC were significantly associated with malignancy on multivariate analysis and provided 91–93% accuracy. Data Conclusion DWI might be used not only for ADC evaluation but also for the morphological evaluation of breast masses to characterize them. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1668–1677