Radiology Division, ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, Naples, Italy.
Radiology Division, ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, Naples, Italy.
Magn Reson Imaging. 2021 Jan;75:51-59. doi: 10.1016/j.mri.2020.10.008. Epub 2020 Oct 17.
The purpose of this study is to assess Blood oxygenation level dependent Magnetic Resonance Imaging (BOLD-MRI) and Diffusion Weighted Magnetic Resonance Imaging (DW-MRI) in the differentiation of benign and malignant breast lesions.
Fifty-nine breast lesions (26 benign and 33 malignant lesions) pathologically proven in 59 patients were included in this retrospective study. As BOLD parameters were estimated basal signal S and the relaxation rate R2*, diffusion and perfusion parameters were derived by DWI (pseudo-diffusion coefficient (Dp), perfusion fraction (fp) and tissue diffusivity (Dt)). Wilcoxon-Mann-Whitney U test and Receiver operating characteristic (ROC) analyses were calculated and area under ROC curve (AUC) was obtained. Moreover, pattern recognition approaches (linear discrimination analysis (LDA), support vector machine, k-nearest neighbours, decision tree) with least absolute shrinkage and selection operator (LASSO) method and leave one out cross validation approach were considered.
A significant discrimination was obtained by the standard deviation value of S0, as BOLD parameter, that reached an AUC of 0.76 with a sensitivity of 65%, a specificity of 85% and an accuracy of 76%. No significant discrimination was obtained considering diffusion and perfusion parameters. Considering LASSO results, the features to use as predictors were all extracted parameters except that the mean value of R2* and the best result was obtained by a LDA that obtained an AUC = 0.83, with a sensitivity of 88%, a specificity of 77% and an accuracy of 83%.
Good performance to discriminate benign and malignant lesions could be obtained using BOLD and DWI derived parameters with a LDA classification approach. However, these findings should be proven on larger and several dataset with different MR scanners.
本研究旨在评估血氧水平依赖磁共振成像（BOLD-MRI）和弥散加权磁共振成像（DW-MRI）在鉴别良恶性乳腺病变中的作用。
回顾性分析 59 例经病理证实的乳腺病变患者（26 例良性病变，33 例恶性病变）的临床资料。BOLD 参数包括基础信号 S 和弛豫率 R2*，弥散和灌注参数通过 DWI 获得（假性扩散系数 Dp、灌注分数 fp 和组织弥散系数 Dt）。采用 Wilcoxon-Mann-Whitney U 检验和受试者工作特征（ROC）曲线分析，计算 ROC 曲线下面积（AUC）。此外，还采用了线性判别分析（LDA）、支持向量机（SVM）、k-最近邻（kNN）、决策树等模式识别方法，并结合最小绝对收缩和选择算子（LASSO）法和留一法进行了分析。
BOLD 参数 S0 的标准差值可显著区分良恶性病变，AUC 为 0.76，灵敏度为 65%，特异度为 85%，准确率为 76%。考虑弥散和灌注参数时，无法进行显著区分。考虑 LASSO 结果，除 R2*的平均值外，所有提取的参数均可作为预测因子，最佳结果由 LDA 获得，AUC 为 0.83，灵敏度为 88%，特异度为 77%，准确率为 83%。
BOLD 和 DWI 衍生参数结合 LDA 分类方法可较好地区分良恶性病变，但这些发现还需在更大、不同磁共振扫描仪的数据集上进一步验证。
