Dataset Information

Differentiation of malignant and benign breast lesions: Added value of the qualitative analysis of breast lesions on diffusion-weighted imaging (DWI) using readout-segmented echo-planar imaging at 3.0 T.

ABSTRACT:

Objective

To determine the added value of qualitative analysis as an adjunct to quantitative analysis for the discrimination of benign and malignant lesions in patients with breast cancer using diffusion-weighted imaging (DWI) with readout-segmented echo-planar imaging (rs-EPI).

Methods

A total of 99 patients with 144 lesions were reviewed from our prospectively collected database. DWI data were obtained using rs-EPI acquired at 3.0 T. The diagnostic performances of DWI in the qualitative, quantitative, and combination analyses were compared with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Additionally, the effect of lesion size on the diagnostic performance of the DWI combination analysis was evaluated.

Results

The strongest indicators of malignancy on DWI were a heterogeneous pattern (P = 0.005) and an apparent diffusion coefficient (ADC) value <1.0 × 10-3 mm2/sec (P = 0.002). The area under the curve (AUC) values for the qualitative analysis, quantitative analysis, and combination analysis on DWI were 0.732 (95% CI, 0.651-0.803), 0.780 (95% CI, 0.703-0.846), and 0.826 (95% CI, 0.754-0.885), respectively (P<0.0001). The AUC for the combination analysis on DWI was superior to that for DCE-MRI alone (0.651, P = 0.003) but inferior to that for DCE-MRI plus the ADC value (0.883, P = 0.03). For the DWI combination analysis, the sensitivity was significantly lower in the size ?1 cm group than in the size >1 cm group (80% vs. 95.6%, P = 0.034).

Conclusions

Qualitative analysis of tumor morphology was diagnostically applicable on DWI using rs-EPI. This qualitative analysis adds value to quantitative analyses for lesion characterization in patients with breast cancer.

SUBMITTER: An YY

PROVIDER: S-EPMC5373600 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Differentiation of malignant and benign breast lesions: Added value of the qualitative analysis of breast lesions on diffusion-weighted imaging (DWI) using readout-segmented echo-planar imaging at 3.0 T.

An Yeong Yi YY Kim Sung Hun SH Kang Bong Joo BJ

PloS one 20170330 3

<h4>Objective</h4>To determine the added value of qualitative analysis as an adjunct to quantitative analysis for the discrimination of benign and malignant lesions in patients with breast cancer using diffusion-weighted imaging (DWI) with readout-segmented echo-planar imaging (rs-EPI).<h4>Methods</h4>A total of 99 patients with 144 lesions were reviewed from our prospectively collected database. DWI data were obtained using rs-EPI acquired at 3.0 T. The diagnostic performances of DWI in the qua ...[more]

PMID: 28358833

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Project description:BackgroundHistogram analysis of the diffusion-weighted imaging (DWI) parameters is widely used to differentiate the breast lesions. However, histogram analysis of the diffusion-kurtosis imaging (DKI) parameters for the single-shot echo-planar imaging (ss-EPI) and readout-segmented echo planar imaging (rs-EPI) sequences has not been compared in breast cancer. Thus, this study is to investigate the diagnostic accuracy and reliability of the histogram parameters derived from the rs-EPI and ss-EPI sequences of DKI parameters in distinguishing between the benign and malignant breast lesions.MethodsThis single-center, retrospective cohort study enrolled 205 consecutive patients with breast lesions (65 benign and 140 malignant). The patients underwent breast magnetic resonance imaging (MRI) with a 3T scanner using the rs-EPI and ss-EPI sequences with 4 b values (0, 50, 1,000, and 2,000 s/mm2). The regions of interest (ROIs) were manually delineated for all the lesion images from both the sequences, and the histogram parameters were extracted from the apparent diffusion coefficient (ADC) and apparent diffusional kurtosis (Kapp) maps. Statistical analysis was performed using the Kolmogorov-Smirnov test, the student's t-test, and the receiver operating characteristic (ROC) curves.ResultsThe mean, 25th, 50th, 75th, and 100th percentiles, skewness, and kurtosis values derived from apparent diffusion for non-Gaussian distribution (Dapp) and Kapp maps showed good or excellent intra-observer agreement (ICC: 0.695 to 0.863).The mean and the 25th, 50th, 75th, and 100th percentile values for Dapp were significantly lower and the mean and the 25th, 50th, 75th, and 100th percentile values for Kapp were significantly higher in the malignant breast lesions compared with those in the benign breast lesions for both the rs-EPI and ss-EPI sequences (all P<0.05). The majority of the histogram Kapp and Dapp parameters (except skewness and kurtosis) for the benign and malignant lesions showed significant differences between the ss-EPI and the rs-EPI sequences (P<0.05). ROC curve analysis showed that the AUC values for the 75th percentile of Kapp (0.854 for rs-EPI, 0.844 for ss-EPI) and the 25th percentile of Dapp (0.866 for rs-EPI, 0.858 for ss-EPI) were highest for both DKI sequences. The diagnostic performance of the rs-EPI sequence was better than the ss-EPI sequence for all the histogram parameters except the skewness value of Dapp.ConclusionsHistogram parameters from the rs-EPI sequence were more reliable and accurate in differentiating malignant and benign breast lesions than those from the ss-EPI sequence.

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Dataset Information

Differentiation of malignant and benign breast lesions: Added value of the qualitative analysis of breast lesions on diffusion-weighted imaging (DWI) using readout-segmented echo-planar imaging at 3.0 T.

Objective

Methods

Results

Conclusions

Publications

Differentiation of malignant and benign breast lesions: Added value of the qualitative analysis of breast lesions on diffusion-weighted imaging (DWI) using readout-segmented echo-planar imaging at 3.0 T.

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