Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia.
J Magn Reson Imaging. 2019 May;49(5):1381-1390. doi: 10.1002/jmri.26332. Epub 2018 Oct 16.
The capability of diffusion-weighted imaging (DWI) for morphological analysis of breast lesions is underexplored.
To evaluate the utility of DWI for assessment of morphological features of breast cancer by comparing DWI and dynamic contrast-enhanced (DCE) MRI findings to determine intermethod and interobserver agreement.
Retrospective.
Seventy-eight women with pathohistologically proven breast cancer.
FIELD STRENGTH/SEQUENCE: 1.5T. DWI and DCE images.
Diffusion-weighted and DCE images were placed in two separate case sets. Three radiologists, blinded to all other information, independently evaluated each case set on two separate occasions. Lesions were interpreted according to the fifth edition of the ACR BI-RADS lexicon.
Kappa (κ) statistics were calculated in order to assess intermethod and interobserver agreement.
For values that attained statistical significance (P < 0.05), intermethod agreement ranged from fair (κ = 0.22) for nonmass internal patterns to significant (κ = 0.8) for lesion type. On DWI, interobserver agreement varied from fair (κ = 0.34) for mass shape to significant (κ = 0.75) for lesion type. On DCE MRI, interobserver agreement varied from fair (κ = 0.27) for irregular vs. spiculated mass margin to perfect (κ = 1) for circumscribed vs. noncircumscribed mass margin.
On the whole, there was moderate intermethod agreement. The values of interobserver agreement were mostly similar between DWI and DCE MRI. This suggests that DWI is applicable for morphological assessment of breast cancer, notwithstanding substantially inferior spatial resolution compared to DCE MRI.
3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:1381-1390.
扩散加权成像（DWI）在乳腺病变形态学分析中的应用能力尚未得到充分探索。
通过比较 DWI 和动态对比增强（DCE）MRI 检查结果，评估 DWI 对乳腺癌形态特征评估的作用，以确定方法间和观察者间的一致性。
回顾性。
78 名经病理证实患有乳腺癌的女性。
磁场强度/序列：1.5T。DWI 和 DCE 图像。
DWI 和 DCE 图像被放置在两个独立的病例组中。三位放射科医生在两次不同的就诊中，在不了解其他信息的情况下，分别对每个病例组进行独立评估。病变根据第五版 ACR BI-RADS 词汇进行解读。
计算 Kappa（κ）统计量以评估方法间和观察者间的一致性。
对于达到统计学意义（P < 0.05）的数值，非肿块型内部形态的方法间一致性为差（κ=0.22），至病变类型的一致性为显著（κ=0.8）。在 DWI 上，形态的观察者间一致性从肿块形状的差（κ=0.34）到病变类型的显著（κ=0.75）不等。在 DCE MRI 上，观察者间一致性从不规则/分叶状肿块边缘的差（κ=0.27）到边界清晰/非边界清晰肿块边缘的完美（κ=1）不等。
总的来说，方法间存在中度一致性。DWI 和 DCE MRI 之间的观察者间一致性值大多相似。这表明尽管与 DCE MRI 相比，DWI 的空间分辨率要低得多，但它适用于乳腺癌的形态评估。
3 技术功效：3 级。J. 磁共振成像 2019；49：1381-1390。
