A comparative study of the value of amide proton transfer-weighted imaging and diffusion kurtosis imaging in the diagnosis and evaluation of breast cancer

Objectives To compare the value of amide proton transfer-weighted imaging (APTWI) and diffusion kurtosis imaging (DKI) in differentiating benign and malignant breast lesions and analyze the correlations between the derived parameters and prognostic factors of breast cancer. Methods One hundred thirty-five women underwent breast APTWI and DKI. The magnetization transfer ratio asymmetry (MTRasym (3.5 ppm)), apparent kurtosis coefficient (K-app), and non-Gaussian diffusion coefficient (D-app) were calculated according to the histological subtype, grade, and prognostic factors (Ki-67, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), lymph node metastasis, and maximum lesion diameter). The differences, efficacy, and correlation between the parameters were determined. Results TheK(app)value was higher and theD(app)and MTRasym (3.5 ppm) values were lower in the malignant group than in the benign group (allp< 0.001; AUC (K-app) = 0.913, AUC (D-app) = 0.910, and AUC (MTRasym (3.5 ppm)) = 0.796). The differences in the AUC betweenK(app)and MTRasym (3.5 ppm) and betweenD(app)and MTRasym (3.5 ppm) were significant (p= 0.023, 0.046).K(app)was moderately correlated with the pathological grade (|r| = 0.724) and mildly correlated with Ki-67 and HER-2 expression (|r| = 0.454, 0.333).D(app)was moderately correlated with the pathological grade (|r| = 0.648) and mildly correlated with Ki-67 expression (|r| = 0.400). MTRasym (3.5 ppm) was only mildly correlated with the pathological grade (|r| = 0.468). Conclusion DKI is superior to APTWI in differentiating between benign and malignant breast lesions. Each parameter is correlated with some prognostic factors to a certain extent.

Automated summary

DKI is superior to APTWI in differentiating between benign and malignant breast lesions. Each parameter is correlated with some prognostic factors to a certain extent.