Fueger Barbara J, Varga Raoul, Kapetas Panagiotis, Pötsch Nina, Helbich Thomas H, Baltzer Pascal A T, Clauser Paola
Department of Biomedical Imaging and Image-guided Biopsy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.
Magn Reson Med Sci. 2025 Jul 31;24(4). doi: 10.2463/mrms.mp.2023-0131. Epub 2024 Jul 13.
Gadolinium-based contrast media (GBCM) may affect apparent diffusion coefficient measurements on diffusion-weighted imaging. We aimed at investigating the effect of GBCM and inter-reader variation on intravoxel incoherent motion (IVIM) parameters in breast lesions.
A total of 89 patients referred to 3T breast MRI with at least one histologically verified lesion were included. IVIM data were acquired using a single-shot echo planar imaging sequence before and after GBCM administration. D (true diffusion coefficient), D* (pseudo-diffusion coefficient) and f (perfusion fraction) were calculated and measured by two readers (R1, R2). Inter-reader and intra-reader agreements were assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots.
D was comparable before and after GBCM administration and between readers. D* and f decreased after GBCM administration and showed a lower agreement between readers. Intra-reader agreement before and after GBCM administration was almost perfect for D for both R1 and R2 (ICC 0.955 and 0.887). The intra-reader agreement was substantial to moderate for D* (ICC R1 0.708, R2 0.583) and moderate for f (ICC R1 0.529 and R2 0.425). Inter-reader agreement before GBCM administration was almost perfect for D (ICC 0.905), substantial for D* (ICC 0.733), and moderate for f (ICC 0.404); after contrast media administration, it was almost perfect for D (ICC 0.876) and substantial for D* (ICC 0.654) and f (ICC 0.606). Bland-Altman plots revealed no significant bias.
Administration of GBCM seems to have a stronger effect on D* and f values than on D values. This should be considered when applying IVIM in clinical practice.
钆基造影剂（GBCM）可能会影响扩散加权成像上的表观扩散系数测量。我们旨在研究GBCM和阅片者间差异对乳腺病变体素内不相干运动（IVIM）参数的影响。
纳入89例转诊至3T乳腺MRI且至少有1个经组织学证实病变的患者。在给予GBCM之前和之后，使用单次激发回波平面成像序列采集IVIM数据。由两名阅片者（R1、R2）计算并测量D（真实扩散系数）、D*（伪扩散系数）和f（灌注分数）。通过组内相关系数（ICC）和Bland-Altman图评估阅片者间和阅片者内的一致性。
GBCM给药前后以及阅片者之间，D值具有可比性。GBCM给药后，D和f降低，且阅片者之间的一致性较低。对于R1和R2，GBCM给药前后阅片者内D的一致性几乎完美（ICC分别为0.955和0.887）。阅片者内D的一致性为中等至实质（ICC：R1为0.708，R2为0.583），f的一致性为中等（ICC：R1为0.529，R2为0.425）。GBCM给药前，阅片者间D的一致性几乎完美（ICC为0.905），D为实质（ICC为0.733），f为中等（ICC为0.404）；造影剂给药后，D的一致性几乎完美（ICC为0.876），D为实质（ICC为0.654），f为实质（ICC为0.606）。Bland-Altman图显示无显著偏差。
GBCM给药对D*和f值的影响似乎比对D值的影响更大。在临床实践中应用IVIM时应考虑这一点。
