Journal
EUROPEAN JOURNAL OF RADIOLOGY
Volume 145, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ejrad.2021.110014
Keywords
Breast neoplasms; Magnetic resonance imaging; Diffusion-weighted MRI; Kurtosis; Prognostic factors
Funding
- National Natural Science Foundation of China [82001892]
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The study found that DKI is not superior to conventional DWI in differentiating suspicious breast lesions and reflecting prognostic information of breast cancer. The ADC, K-app and D-app were correlated with HER2 expression and lymph node status, and ADC and K-app differed between ER-positive and negative tumors.
Purpose: To investigate the additional value of DKI in discriminating suspicious breast lesions on DCE-MRI, as compared with conventional DWI; and to explore connection between DKI-parameters and prognostic factors of breast cancers. Methods: The institutional review board approved this retrospective study and written informed consent was waived. Totally, 300 women (mean age, 43.2 +/- 10.4 years) with suspicious breast lesions on DCE-MRI were enrolled from November 2014 to September 2019. With pathology as reference, performance of ADC, K-app and D-app in discriminating suspicious breast lesions were analyzed by receiver operating characteristic (ROC) analysis with area under ROC curve (AUC). The specificities of parameters were compared by Chi-square test. The ADC, K-app and D-app of breast cancers with different receptor status were compared using Student's t or Mann-Whitney U or Kruskal-Wallis test. Results: There were 344 suspicious breast lesions (220 malignant, 124 benign) in 300 women. No significant differences were found for AUCs of ADC and DKI-parameters in discriminating suspicious breast lesions (0.882 vs. 0.888, p = 0.480). The specificities were significantly higher with ADC and Dapp than that with DCE-MRI (p = 0.003 and 0.005). The ADC, K-app and D-app were correlated with HER2 expression and lymph node status, and ADC and K-app differed between ER-positive and negative tumors (all p < 0.05). Except K-app, DKI/DWI-parameters showed relation with Ki-67 expression. None of the DKI/DWI-parameters showed relation with lesion grade (all p > 0.05). Conclusion: The more complicated and time-consuming DKI is not superior to conventional DWI in differentiating suspicious breast lesions and reflecting prognostic information of breast cancer.
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