Diffusion Kurtosis at 3.0T as an in vivo Imaging Marker for Breast Cancer Characterization: Correlation With Prognostic Factors

作者：Huang, Yao; Lin, Yan^*; Hu, Wei; Ma, Changchun; Lin, Weixun; Wang, Zhening; Liang, Jiahao; Ye, Wei; Zhao, Jiayun; Wu, Renhua

来源：Journal of Magnetic Resonance Imaging, 2019, 49(3): 845-856.

DOI：10.1002/jmri.26249

• MRI
• breast cancer
• risk stratification
• diffusion kurtosis

BackgroundDiffusion-kurtosis imaging (DKI) has preliminarily shown promise as a relatively new MRI technique to provide useful information regarding breast lesions, but the diagnostic performance of DKI has not been fully evaluated. @@@ PurposeTo compare the diagnostic accuracy of DKI, diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE)-MRI) and proton MR spectroscopy (H-1-MRS) in differentiating malignant from benign breast lesions independently or jointly, and explore the correlation between DKI-derived parameters and prognostic factors. @@@ Study TypeProspective. @@@ SubjectsSeventy-one patients with breast lesions (50 malignant, 26 benign). @@@ SequenceDKI, DWI, DCE-MRI, and H-1-MRS were performed at 3.0T. @@@ AssessmentMean kurtosis (MK), mean diffusivity (MD), apparent diffusion coefficient (ADC), BI-RADS category, and choline peaks were analyzed by two experienced radiologists. @@@ Statistical TestsStudent's t-test was used for continuous variables; receiver operating characteristic (ROC) analysis for assessing the diagnostic accuracy of imaging parameters; Spearman or Pearson correlations for assessing the associations between imaging parameters and prognostic factors. @@@ ResultsMK exhibited higher area under the curves (AUCs) for differentiating malignant from benign lesions than did MD, ADC, DCE, and tCho (0.979 vs. 0.928, 0.911, 0.777, and 0.833, respectively, P<0.05). MK showed a positive association with Ki-67 expression (r=0.508) and histologic grades (r=0.551), whereas MD and ADC were negatively correlated with Ki-67 expression (r=-0.416 and r=-0.458) and histologic grades (r=-0.411 and r=-0.319). Moreover, MK showed relatively higher AUCs compared with MD and ADC in detecting breast cancers with lymph nodal involvement, histologic grades, and Ki-67 expression. @@@ Data ConclusionMK has higher diagnostic accuracy compared with ADC, DCE, and tCho regarding detection of breast cancer. Moreover, DKI shows promise as a quantitative imaging technique for characterizing breast lesions, highlighting the potential utility of MK as a promising imaging marker for predicting tumor aggressiveness. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:845-856.

• 出版日期2019-3
• 单位汕头大学