Multiple parameters from ultrafast dynamic contrast-enhanced magnetic resonance imaging to discriminate between benign and malignant breast lesions: Comparison with apparent diffusion coefficient

Purpose: The purpose of this study was first to assess the diagnostic performance of ultrafast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters compared to apparent diffusion coefficient (ADC) for distinguishing benign from malignant breast lesions and second to investigate the complementarity of ultrafast DCE-MRI with DWI in that task. Materials and methods: A total of 142 women (mean age, 48.42 11.03 [SD]) years; range: 14-78 years) with 150 breast lesions who underwent breast ultrafast DCE-MRI were prospectively recruited. Ultrafast DCE-MRI semi-quantitative parameters (maximum slope [MS], time to peak [TTP], time to enhancement [TTE], and initial area under curve in 60 s [iAUC]), ultrafast DCE-MRI quantitative parameters (Kep, Ktrans, and Ve), and the ADC were estimated and compared between benign and malignant breast lesions. Classification performances were assessed using area under the receiver operating characteristic curve (AUC) and compared using Delong test. Results: The ultrafast DCE-MRI semi-quantitative multiparameters (AUC, 0.913; 95% CI: 0.856-0.953) showed better classification performance than the quantitative multiparameters (AUC, 0.818; 95% CI: 0.747-0.876) (P = 0.022). No differences in AUC were found between ultrafast DCE-MRI semi-quantitative multiparameters and ADC (AUC, 0.912; 95% CI: 0.855-0.952) (P = 0.990). The combination of ultrafast DCE-MRI semi-quantitative multiparameters and ADC (AUC, 0.960; 95% CI: 0.915-0.985) showed better classification performance than the ultrafast DCE-MRI semi-quantitative multiparameters (P = 0.014) and quantitative multiparameters (P < 0.001). Conclusion: Ultrafast DCE-MRI can be used as an accurate method for discriminating benign from malignant breast lesions. The combination of ultrafast DCE-MRI and DWI significantly increases the diagnostic value of ultrafast DCE-MRI. (c) 2023 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

The purpose of this study was to assess the diagnostic performance of Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) parameters compared to Apparent Diffusion Coefficient (ADC) for distinguishing benign from malignant breast lesions, and to investigate the complementarity of ultrafast DCE-MRI with Diffusion Weighted Imaging (DWI). The results showed that ultrafast DCE-MRI semi-quantitative parameters had better classification performance than quantitative parameters, and the combination of ultrafast DCE-MRI semi-quantitative parameters and ADC further improved the diagnostic value of ultrafast DCE-MRI.