Qualitative characterization of breast tumors with diffusion-weighted imaging has comparable accuracy to quantitative analysis
| Autor: | Musa Kul, Sibel Kul, Suleyman Bekircavusoglu, Yavuz Metin |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Contrast Media
BI-RADS Breast Neoplasms Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Effective diffusion coefficient Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Medical diagnosis Retrospective Studies medicine.diagnostic_test Receiver operating characteristic business.industry Magnetic resonance imaging Magnetic Resonance Imaging Diffusion Magnetic Resonance Imaging 030220 oncology & carcinogenesis Dynamic contrast-enhanced MRI Female Nuclear medicine business Kappa Diffusion MRI |
| Zdroj: | Clinical imaging. 77 |
| ISSN: | 1873-4499 |
| Popis: | To evaluate the applicability and accuracy of a new qualitative diffusion-weighted imaging (DWI) assessment method in the characterization of breast tumors compared to quantitative ADC measurement and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI).After review board approval, MRIs of 216 consecutive women with final diagnoses (131 malignant, 85 benign) were retrospectively analyzed. Two radiologists independently scored DWI and dynamic contrast-enhanced MRI (DCE-MRI) according to malignancy probability. Qualitative assessments were performed by combined analysis of tumor morphology and diffusion signal. Quantitative data was obtained from apparent diffusion coefficient (ADC) measurements. Lastly, descriptive DWI features were evaluated and recorded. Cohen's kappa, receiver operating characteristic and multivariate analyzes were applied.Of malignant tumors, 97% were visible on DWI. Qualitative and quantitative DWI assessments provided comparable sensitivities of 89-94% and 88-92% and specificities of 51-61% and 59-67%, respectively. There was no statistical difference between the accuracies of qualitative and quantitative DWI (p ≥ 0.105). Best diagnostic values were obtained with DCE-MRI (sensitivity, 99-100%; specificity, 69-71%). Inter-reader agreement was moderate (kappa = 0.597) for qualitative DWI and substantial (kappa = 0.689) for DCE-MRI (p 0.001). Agreement between qualitative DWI and DCE-MRI scores was moderate (kappa = 0.536 and 0.442). Visual diffusion signal, mass margin and shape were the most predictive features of malignancy on multivariate analysis of qualitative assessment.Qualitative characterization of breast tumors on DWI has comparable accuracy to quantitative ADC analysis. This method might be used to make DWI more widely available with eliminating the need to a predetermined ADC threshold in tumor characterization. However, lower accuracy and inter-reader agreement of it compared to DCE-MRI should be considered. |
| Databáze: | OpenAIRE |
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