School of Medicine, Chongqing University, Chongqing 400030, China.
Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China.
Diagn Interv Imaging. 2023 Jun;104(6):275-283. doi: 10.1016/j.diii.2023.01.006. Epub 2023 Feb 2.
The purpose of this study was first to assess the diagnostic performance of ultrafast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters compared to apparent diffusion coefficient (ADC) for distinguishing benign from malignant breast lesions and second to investigate the complementarity of ultrafast DCE-MRI with DWI in that task.
A total of 142 women (mean age, 48.42 ± 11.03 [SD]) years; range: 14-78 years) with 150 breast lesions who underwent breast ultrafast DCE-MRI were prospectively recruited. Ultrafast DCE-MRI semi-quantitative parameters (maximum slope [MS], time to peak [TTP], time to enhancement [TTE], and initial area under curve in 60 s [iAUC]), ultrafast DCE-MRI quantitative parameters (K, K, and V), and the ADC were estimated and compared between benign and malignant breast lesions. Classification performances were assessed using area under the receiver operating characteristic curve (AUC) and compared using Delong test.
The ultrafast DCE-MRI semi-quantitative multiparameters (AUC, 0.913; 95% CI: 0.856-0.953) showed better classification performance than the quantitative multiparameters (AUC, 0.818; 95% CI: 0.747-0.876) (P = 0.022). No differences in AUC were found between ultrafast DCE-MRI semi-quantitative multiparameters and ADC (AUC, 0.912; 95% CI: 0.855-0.952) (P = 0.990). The combination of ultrafast DCE-MRI semi-quantitative multiparameters and ADC (AUC, 0.960; 95% CI: 0.915-0.985) showed better classification performance than the ultrafast DCE-MRI semi-quantitative multiparameters (P = 0.014) and quantitative multiparameters (P < 0.001).
Ultrafast DCE-MRI can be used as an accurate method for discriminating benign from malignant breast lesions. The combination of ultrafast DCE-MRI and DWI significantly increases the diagnostic value of ultrafast DCE-MRI.
本研究首先旨在评估超快速动态对比增强磁共振成像（DCE-MRI）参数与表观扩散系数（ADC）相比，在区分良性和恶性乳腺病变方面的诊断性能，其次旨在研究超快速 DCE-MRI 与 DWI 在该任务中的互补性。
本研究前瞻性招募了 142 名女性（平均年龄 48.42±11.03[SD]岁；范围：14-78 岁），共 150 个乳腺病变患者，行乳腺超快速 DCE-MRI 检查。评估并比较了超快速 DCE-MRI 半定量参数（最大斜率[MS]、达峰时间[TTP]、增强时间[TTE]和 60s 时初始曲线下面积[iAUC]）、超快速 DCE-MRI 定量参数（Ktrans、Kep 和 V）与良性和恶性乳腺病变之间的 ADC。使用受试者工作特征曲线下面积（AUC）评估分类性能，并使用 Delong 检验进行比较。
超快速 DCE-MRI 半定量多参数（AUC，0.913；95%CI：0.856-0.953）的分类性能优于定量多参数（AUC，0.818；95%CI：0.747-0.876）（P=0.022）。超快速 DCE-MRI 半定量多参数与 ADC 的 AUC 无差异（AUC，0.912；95%CI：0.855-0.952）（P=0.990）。超快速 DCE-MRI 半定量多参数与 ADC 的联合（AUC，0.960；95%CI：0.915-0.985）的分类性能优于超快速 DCE-MRI 半定量多参数（P=0.014）和定量多参数（P<0.001）。
超快速 DCE-MRI 可作为区分良性和恶性乳腺病变的准确方法。超快速 DCE-MRI 与 DWI 的联合应用显著提高了超快速 DCE-MRI 的诊断价值。
