Diffusional kurtosis imaging for differentiation of additional suspicious lesions on preoperative breast MRI of patients with known breast cancer.

TitleDiffusional kurtosis imaging for differentiation of additional suspicious lesions on preoperative breast MRI of patients with known breast cancer.
Publication TypeJournal Article
Year of Publication2019
AuthorsPark VYoungjean, Kim SG, Kim E-K, Moon HJung, Yoon JHyun, Kim MJung
JournalMagn Reson Imaging
Volume62
Pagination199-208
Date Published2019 10
ISSN1873-5894
KeywordsAdult, Aged, Breast, Breast Neoplasms, Cell Differentiation, Diffusion Magnetic Resonance Imaging, Diffusion Tensor Imaging, Echo-Planar Imaging, Female, Humans, Image Interpretation, Computer-Assisted, Middle Aged, Preoperative Period, Retrospective Studies, ROC Curve, Sensitivity and Specificity
Abstract

PURPOSE: To investigate the potential of diffusional kurtosis imaging (DKI) and conventional diffusion-weighted imaging (DWI) in the evaluation of additional suspicious lesions at preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer.

MATERIALS AND METHODS: Fifty-three additional suspicious lesions in 45 patients with breast cancer, which were detected on preoperative breast MRI, were examined with a 3-T MR system. DKI and DWI data were obtained using a spin-echo single-shot echo-planar imaging sequence with b-values of 0, 50, 600, 1000, and 3000 s/mm. Histogram parameters (mean, standard deviation, minimum, maximum, 10th, 25th, 50th, 75th, 90th percentiles, kurtosis, skewness and entropy) of ADC from DWI and diffusivity (D), kurtosis (K) from DKI were calculated after postprocessing. Parameters were compared between benign vs. ductal carcinoma in situ (DCIS) vs. invasive breast lesions and diagnostic performances were evaluated by receiver operating characteristic (ROC) analysis. Correlation between the mean values of D and K was analyzed according to lesion type.

RESULTS: Multiple histogram parameters of D (mean, 25th, 50th percentile, 75th percentile, and entropy) differed between benign and invasive breast lesions (all P < 0.005), but none differed between benign vs. DCIS. D-90th percentile differed between DCIS vs. invasive cancer (P = 0.040). K-10th percentile differed between benign vs. DCIS (P = 0.015). ADC-75th percentile differed between benign vs. invasive cancer and ADC-75th percentile, ADC-90th percentile differed between DCIS vs. invasive cancer, respectively (all P < 0.005). ROC curve analysis showed high specificity for discrimination between benign and invasive cancer. D-mean and K-mean showed strong correlation in benign (r = -0.813) and invasive lesions (r = -0.853), but no significant correlation in DCIS.

CONCLUSION: DKI may aid in the differentiation of additional suspicious lesions at preoperative breast MRI. Both ADC and DKI may have lower potential in differentiating DCIS from benign lesions.

DOI10.1016/j.mri.2019.07.011
Alternate JournalMagn Reson Imaging
PubMed ID31323316
PubMed Central IDPMC6945504
Grant ListP41 EB017183 / EB / NIBIB NIH HHS / United States
Related Institute: 
MRI Research Institute (MRIRI)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065