Intravoxel incoherent motion diffusion‐weighted MRI at 3.0 T differentiates malignant breast lesions from benign lesions and breast parenchyma. Issue 4 (22nd November 2013)

• Record Type: Journal Article
• Authors: Bokacheva, Louisa; Kaplan, Jennifer B.; Giri, Dilip D.; Patil, Sujata; Gnanasigamani, Merlin; Nyman, C. Gregory; Deasy, Joseph O.; Morris, Elizabeth A.; Thakur, Sunitha B.
• Is Part Of: Journal of magnetic resonance imaging. Volume 40:Issue 4(2014)
• Page Start: 813
• Page End: 823
• Publication Date: 2013-11-22
• Subjects: Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.24462
• Languages: English
• ISSNs: 1053-1807

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jmri24462-sec-0001" sec-type="section"> <title>Purpose</title> <p>To study the differentiation of malignant breast lesions from benign lesions and fibroglandular tissue (FGT) using apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters.</p> </sec> <sec id="jmri24462-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>This retrospective study included 26 malignant and 14 benign breast lesions in 35 patients who underwent diffusion‐weighted MRI at 3.0T and nine b‐values (0–1000 s/mm<sup>2</sup>). ADC and IVIM parameters (perfusion fraction f<sub>p</sub>, pseudodiffusion coefficient D<sub>p</sub>, and true diffusion coefficient D<sub>d</sub>) were determined in lesions and FGT. For comparison, IVIM was also measured in 16 high‐risk normal patients. A predictive model was constructed using linear discriminant analysis. Lesion discrimination based on ADC and IVIM parameters was assessed using receiver operating characteristic (ROC) and area under the ROC curve (AUC).</p> </sec> <sec id="jmri24462-sec-0003" sec-type="section"> <title>Results</title> <p>In FGT of normal subjects, f<sub>p</sub> was 1.1 ± 1.1%. In malignant lesions, f<sub>p</sub> (6.4 ± 3.1%) was significantly higher than in benign lesions (3.1 ± 3.3%, <italic>P</italic> = 0.0025) or FGT (1.5 ± 1.2%, <italic>P</italic> < 0.001), and D<sub>d</sub> ((1.29 ± 0.28) × 10<sup>−3</sup> mm<sup>2</sup>/s) was lower than in benign lesions ((1.56 ± 0.28) × 10<sup>−3</sup> mm<sup>2</sup>/s, <italic>P</italic> = 0.011) or FGT ((1.86 ± 0.34) × 10<sup>−3</sup> mm<sup>2</sup>/s, <italic>P</italic> < 0.001). A combination of D<sub>d</sub> and f<sub>p</sub> provided higher AUC for discrimination between malignant and benign lesions (0.84) or FGT (0.97) than ADC (0.72 and 0.86, respectively).</p> </sec> <sec id="jmri24462-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The IVIM parameters provide accurate identification of malignant lesions. <bold>J. Magn. Reson. Imaging 2014;40:813–823</bold>. © <bold>2013 Wiley Periodicals, Inc</bold>.</p> </sec> </abstract>