体素弥散加权成像在乳腺癌中的可行性及诊断性能。
Feasibility and Diagnostic Performance of Voxelwise Computed Diffusion-Weighted Imaging in Breast Cancer.
机构信息
Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, P.R. China.
Department of Thyroid and Breast Surgery, First Affiliated Hospital of Wenzhou Medical University, P.R. China.
出版信息
J Magn Reson Imaging. 2019 Jun;49(6):1610-1616. doi: 10.1002/jmri.26533. Epub 2018 Oct 16.
BACKGROUND
Conventional diffusion-weighted imaging (DWI) with high b-values may improve lesion conspicuity, but with a low signal intensity and thus a low signal-to-noise ratio (SNR). The voxelwise computed DWI (vcDWI) may generate high-quality images with a strong lesion signal and low background.
PURPOSE
To evaluate the feasibility and diagnostic performance of vcDWI.
STUDY TYPE
Retrospective.
POPULATION
In all, 67 patients with 72 lesions, 33 malignant and 39 benign.
FIELD STRENGTH/SEQUENCE: 3T, including T /T , DWI with two b-values, and dynamic contrast-enhanced MRI (DCE-MRI).
ASSESSMENT
Computed DWI (cDWI) with high b-values of 1500, 2000, 2500 s/mm (cDWI , cDWI , cDWI ) and vcDWI were generated from measured DWI (mDWI). The mDWI, cDWIs and vcDWI were evaluated by three readers independently to determine lesion conspicuity, background signal suppression, overall image quality using 1-5 rating scales, as well as to give BI-RADS scores. The mean apparent diffusion coefficient (ADC) value for each lesion was measured.
STATISTICAL TESTS
Agreement among the three readers was evaluated by the intraclass correlation coefficient. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic performance based on reading of mDWI, cDWIs, vcDWI, and the measured ADC values.
RESULTS
vcDWI provided the best lesion conspicuity compared with mDWI and cDWIs (P < 0.005). For overall image quality, vcDWI was significantly better than cDWI (P < 0.005), but not significantly better compared with mDWI for two readers (P = 0.037 and P = 0.013) and significantly worse for the third reader (P < 0.005). Background signal suppression was the best on cDWI , and better on vcDWI than on mDWI, cDWI , and cDWI . The AUC value for differential diagnosis was 0.868 for mDWI, 0.862 for cDWI , 0.781 for cDWI , 0.704 for cDWI , 0.946 for vcDWI, 0.704 for ADC value, and 0.961 for DCE-MRI. DATA CONCLUSION: vcDWI was implemented without increasing scanning time, and it provided excellent lesion conspicuity for detection of breast lesions and assisted in differentiating malignant from benign breast lesions.
LEVEL OF EVIDENCE
4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
背景
常规高 b 值扩散加权成像（DWI）可以提高病变的显著性，但信号强度低，因此信噪比（SNR）低。体素计算 DWI（vcDWI）可以生成具有强病变信号和低背景的高质量图像。
目的
评估 vcDWI 的可行性和诊断性能。
研究类型
回顾性。
人群
共 67 例患者，72 个病灶，33 个恶性病灶和 39 个良性病灶。
场强/序列：3T，包括 T1/T2、两个 b 值的 DWI 和动态对比增强 MRI（DCE-MRI）。
评估
从测量的 DWI（mDWI）生成高 b 值（1500、2000、2500 s/mm）的计算 DWI（cDWI）、cDWI 和 vcDWI。三位读者独立评估 mDWI、cDWIs 和 vcDWI，以确定病变显著性、背景信号抑制、使用 1-5 级评分的整体图像质量，并给出 BI-RADS 评分。测量每个病变的平均表观扩散系数（ADC）值。
统计检验
通过组内相关系数评估三位读者之间的一致性。进行受试者工作特征（ROC）分析，以比较基于 mDWI、cDWIs、vcDWI 和测量 ADC 值的阅读的诊断性能。
结果
与 mDWI 和 cDWIs 相比，vcDWI 提供了最佳的病变显著性（P<0.005）。对于整体图像质量，vcDWI 明显优于 cDWI（P<0.005），但对于两位读者，与 mDWI 相比没有显著改善（P=0.037 和 P=0.013），而对于第三位读者，明显更差（P<0.005）。背景信号抑制在 cDWI 上最佳，在 vcDWI 上优于 mDWI、cDWI 和 cDWI。mDWI 的鉴别诊断 AUC 值为 0.868，cDWI 的 AUC 值为 0.862，cDWI 的 AUC 值为 0.781，cDWI 的 AUC 值为 0.704，vcDWI 的 AUC 值为 0.946，ADC 值的 AUC 值为 0.704，DCE-MRI 的 AUC 值为 0.961。
数据结论
实施 vcDWI 不会增加扫描时间，它可以为检测乳腺病变提供出色的病变显著性，并有助于区分乳腺良恶性病变。
证据水平
4 级技术功效：2 期 J. Magn. Reson. Imaging 2018.
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