The value of whole-tumor histogram and texture analysis based on apparent diffusion coefficient (ADC) maps for the discrimination of breast fibroepithelial lesions: corresponds to clinical management decisions.

PURPOSE

This study aims to comprehensively evaluate the diagnostic value of quantitative parameters extracted from apparent diffusion coefficient (ADC) maps in distinguishing fibroepithelial tumors using whole-tumor histogram and texture analysis.

MATERIALS AND METHODS

This retrospective study included 66 female patients with single phyllodes tumor (PT) and 29 female patients with single fibroadenoma (FA) who underwent preoperative magnetic resonance imaging. By independently performing whole-tumor histogram and texture analysis based on ADC maps, two radiologists extracted seven histogram parameters and four texture parameters. The extracted parameters were compared using univariate analysis to determine their ability to distinguish FAs from PTs, benign PTs from FAs, as well as benign PTs from borderline and malignant PTs.

RESULTS

When FAs and PTs were compared, ADC values of PTs were significantly lower than those of FAs (p < 0.05), whereas other significant extracted parameter values of PTs were significantly higher than those of FAs (p ≤ 0.001); the area under the curve of significant parameters combined was 0.936. Regarding the differences between FAs and benign PTs, ADC, ADC and ADC of FAs were significantly lower than those of benign PT group, and ADC was higher than that of benign PT group (all p < 0.05). Furthermore, ADC, ADC and all texture parameters are significantly higher in the borderline and malignant PT group than in FA and benign PT group (p < 0.05). In addition, ADC of malignant PT group was significantly lower than that of borderline PT group (p = 0.045).

CONCLUSION

The extracted whole-tumor histogram and texture features of ADC maps can improve differential diagnosis of breast fibroepithelial tumors and contribute to optimal selection for clinical management of patients with fibroepithelial tumors.