Intravoxel incoherent motion diffusion-weighted MRI at 3.0 T differentiates malignant breast lesions from benign lesions and breast parenchyma

• Published in: Journal of magnetic resonance imaging Vol. 40; no. 4; pp. 813 - 823
• Main Authors: Bokacheva, Louisa, Kaplan, Jennifer B., Giri, Dilip D., Patil, Sujata, Gnanasigamani, Merlin, Nyman, C. Gregory, Deasy, Joseph O., Morris, Elizabeth A., Thakur, Sunitha B.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2014; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Algorithms; benign breast lesions; Breast - pathology; breast cancer; Breast Neoplasms - classification; Breast Neoplasms - pathology; Diffusion Magnetic Resonance Imaging - methods; diffusion-weighted imaging; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; intravoxel incoherent motion; Magnetic resonance imaging; Middle Aged; Motion; Reproducibility of Results; Sensitivity and Specificity; Tumor Burden; breast cancer; diffusion-weighted imaging; intravoxel incoherent motion; benign breast lesions
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.24462

Purpose To study the differentiation of malignant breast lesions from benign lesions and fibroglandular tissue (FGT) using apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters. Materials and Methods This retrospective study included 26 malignant and 14 benign breast lesions in 35 patients who underwent diffusion‐weighted MRI at 3.0T and nine b‐values (0–1000 s/mm2). ADC and IVIM parameters (perfusion fraction fp, pseudodiffusion coefficient Dp, and true diffusion coefficient Dd) were determined in lesions and FGT. For comparison, IVIM was also measured in 16 high‐risk normal patients. A predictive model was constructed using linear discriminant analysis. Lesion discrimination based on ADC and IVIM parameters was assessed using receiver operating characteristic (ROC) and area under the ROC curve (AUC). Results In FGT of normal subjects, fp was 1.1 ± 1.1%. In malignant lesions, fp (6.4 ± 3.1%) was significantly higher than in benign lesions (3.1 ± 3.3%, P = 0.0025) or FGT (1.5 ± 1.2%, P < 0.001), and Dd ((1.29 ± 0.28) × 10−3 mm2/s) was lower than in benign lesions ((1.56 ± 0.28) × 10−3 mm2/s, P = 0.011) or FGT ((1.86 ± 0.34) × 10−3 mm2/s, P < 0.001). A combination of Dd and fp provided higher AUC for discrimination between malignant and benign lesions (0.84) or FGT (0.97) than ADC (0.72 and 0.86, respectively). Conclusion The IVIM parameters provide accurate identification of malignant lesions. J. Magn. Reson. Imaging 2014;40:813–823. © 2013 Wiley Periodicals, Inc.