Barentsz Maarten W, Taviani Valentina, Chang Jung M, Ikeda Debra M, Miyake Kanae K, Banerjee Suchandrima, van den Bosch Maurice A A J, Hargreaves Brian A, Daniel Bruce L
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Radiology, Stanford University, Stanford, California, USA.
J Magn Reson Imaging. 2015 Dec;42(6):1656-65. doi: 10.1002/jmri.24929. Epub 2015 Apr 24.
To compare the diagnostic value of conventional, bilateral diffusion-weighted imaging (DWI) and high-resolution targeted DWI of known breast lesions.
Twenty-one consecutive patients with known breast cancer or suspicious breast lesions were scanned with the conventional bilateral DWI technique, a high-resolution, reduced field of view (rFOV) DWI technique, and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) (3.0 T). We compared bilateral DWI and rFOV DWI quantitatively by measuring the lesions' apparent diffusion coefficient (ADC) values. For qualitative comparison, three dedicated breast radiologists scored image quality and performed lesion interpretation.
In a phantom, ADC values were in good agreement with the reference values. Twenty-one patients (30 lesions: 14 invasive carcinomas, 10 benign lesions [of which 5 cysts], 3 high-risk, and 3 in situ carcinomas) were included. Cysts and high-risk lesions were excluded from the quantitative analysis. Quantitatively, both bilateral and rFOV DWI measured lower ADC values in invasive tumors than other lesions. In vivo, rFOV DWI gave lower ADC values than bilateral DWI (1.11 × 10(-3) mm(2) /s vs. 1.24 × 10(-3) mm(2) /s, P = 0.002). Regions of interest (ROIs) were comparable in size between the two techniques (2.90 vs. 2.13 cm(2) , P = 0.721). Qualitatively, all three radiologists scored sharpness of rFOV DWI images as significantly higher than bilateral DWI (P ≤ 0.002). Receiver operating characteristic (ROC) curve analysis showed a higher area under the curve (AUC) in BI-RADS classification for rFOV DWI compared to bilateral DWI (0.71 to 0.93 vs. 0.61 to 0.76, respectively).
Tumor morphology can be assessed in more detail with high-resolution DWI (rFOV) than with standard bilateral DWI by providing significantly sharper images.
比较传统双侧扩散加权成像（DWI）和已知乳腺病变的高分辨率靶向DWI的诊断价值。
对21例连续的已知乳腺癌或可疑乳腺病变患者进行传统双侧DWI技术、高分辨率、缩小视野（rFOV）DWI技术和动态对比增强磁共振成像（DCE-MRI）（3.0T）扫描。我们通过测量病变的表观扩散系数（ADC）值对双侧DWI和rFOV DWI进行定量比较。为进行定性比较，三位专业乳腺放射科医生对图像质量进行评分并进行病变解读。
在模型中，ADC值与参考值高度一致。纳入21例患者（30个病变：14例浸润性癌、10例良性病变[其中5例囊肿]、3例高危病变和3例原位癌）。囊肿和高危病变被排除在定量分析之外。定量分析显示，浸润性肿瘤的双侧DWI和rFOV DWI测量的ADC值均低于其他病变。在体内，rFOV DWI的ADC值低于双侧DWI（1.11×10⁻³mm²/s对1.24×10⁻³mm²/s，P = 0.002）。两种技术的感兴趣区（ROI）大小相当（2.90对2.13cm²，P = 0.721）。定性分析中，三位放射科医生均将rFOV DWI图像的清晰度评分显著高于双侧DWI（P≤0.002）。受试者操作特征（ROC）曲线分析显示，与双侧DWI相比，rFOV DWI在BI-RADS分类中的曲线下面积（AUC）更高（分别为0.71至0.93对0.61至0.76）。
高分辨率DWI（rFOV）比标准双侧DWI能提供更清晰的图像，从而更详细地评估肿瘤形态。
