A Simplified Approach to Measure the Effect of the Microvasculature in Diffusion-weighted MR Imaging Applied to Breast Tumors: Preliminary Results

Autor: Hans E. Fjøsne, Agnes Østlie, Tone Frost Bathen, Pål Erik Goa, Jose R. Teruel, Torill Eidhammer Sjøbakk
Rok vydání: 2016
Předmět:
Adult
medicine.medical_specialty
Contrast Media
Breast Neoplasms
Sensitivity and Specificity
Spearman's rank correlation coefficient
030218 nuclear medicine & medical imaging
Diagnosis
Differential
03 medical and health sciences
Meglumine
0302 clinical medicine
Image Interpretation
Computer-Assisted
Biomarkers
Tumor
Organometallic Compounds
Humans
Medicine
Effective diffusion coefficient
Radiology
Nuclear Medicine and imaging
Prospective Studies
skin and connective tissue diseases
Intravoxel incoherent motion
Aged
medicine.diagnostic_test
Receiver operating characteristic
business.industry
Area under the curve
Magnetic resonance imaging
Middle Aged
Diffusion Magnetic Resonance Imaging
030220 oncology & carcinogenesis
Microvessels
Female
Radiology
Differential diagnosis
business
medicine.drug
Zdroj: Radiology. 281:373-381
ISSN: 1527-1315
0033-8419
Popis: Purpose To evaluate the relative change of the apparent diffusion coefficient (ADC) at low- and medium-b-value regimens as a surrogate marker of microcirculation, to study its correlation with dynamic contrast agent-enhanced (DCE) magnetic resonance (MR) imaging-derived parameters, and to assess its potential for differentiation between malignant and benign breast tumors. Materials and Methods Ethics approval and informed consent were obtained. From May 2013 to June 2015, 61 patients diagnosed with either malignant or benign breast tumors were prospectively recruited. All patients were scanned with a 3-T MR imager, including diffusion-weighted imaging (DWI) and DCE MR imaging. Parametric analysis of DWI and DCE MR imaging was performed, including a proposed marker, relative enhanced diffusivity (RED). Spearman correlation was calculated between DCE MR imaging and DWI parameters, and the potential of the different DWI-derived parameters for differentiation between malignant and benign breast tumors was analyzed by dividing the sample into equally sized training and test sets. Optimal cut-off values were determined with receiver operating characteristic curve analysis in the training set, which were then used to evaluate the independent test set. Results RED had a Spearman rank correlation of 0.61 with the initial area under the curve calculated from DCE MR imaging. Furthermore, RED differentiated cancers from benign tumors with an overall accuracy of 90% (27 of 30) on the test set with 88.2% (15 of 17) sensitivity and 92.3% (12 of 13) specificity. Conclusion This study presents promising results introducing a simplified approach to assess results from a DWI protocol sensitive to the intravoxel incoherent motion effect by using only three b values. This approach could potentially aid in the differentiation, characterization, and monitoring of breast pathologies. © RSNA, 2016 Online supplemental material is available for this article.
Databáze: OpenAIRE
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