Readout‐Segmented Echo‐Planar Diffusion‐Weighted MR Imaging Improves the Differentiation of Breast Cancer Receptor Statuses Compared With Conventional Diffusion‐Weighted Imaging

Abstract

Background: Readout-segmented echo-planar diffusion-weighted imaging (RS-EPI) can improve image quality and signalto-noise ratio, the resulting apparent diffusion coefficient (ADC) value acts as a more sensitive biomarker to characterize tumors. However, data regarding the differentiation of breast cancer (BC) receptor statuses using RS-EPI are limited. Purpose: To determine whether RS-EPI improves the differentiation of receptor statuses compared with conventional single-shot (SS) EPI in breast MRI. Study Type: Retrospective. Population: A total of 151 BC women with the mean age of 50.6 years. Field strength/Sequence: A 3 T/ RS-EPI and SS-EPI. Assessment: The ADCs of the lesion and normal background tissue from the two sequences were collected by two radiologists with 15 years of experience working of breast MRI (M.H.Z. and X.F.C.), and a normalized ADC was calculated by dividing the mean ADC value of the lesion by the mean ADC value of the normal background tissue. Statistical Tests: Agreement between the ADC measurements from the two sequences was assessed using the Pearson correlation coefficient and Bland-Altman plots. One-way analysis of variance, Kruskal-Wallis test, and median difference were used to compare the ADC measurements for all lesions and different receptor statuses. A P value less than 0.05 indicated a significant result. Results: The ADC measurements of all lesions and normal background tissues were significantly higher on RS-EPI than on SS-EPI (1.82 AE 0.33 vs. 1.55 AE 0.30 and 0.83 AE 0.11 vs. 0.79 AE 0.10). The normalized ADC was lower on RS-EPI than on SS-EPI (0.47 AE 0.11 vs. 0.53 AE 0.12, a median difference of À0.04 [95% CI: À0.256 to 0.111]). For both diffusion methods, only the ADC measurement of RS-EPI was higher for human epidermal growth factor receptor-2 (HER-2)-positive tumors than for HER-2-negative tumors (0.87 AE 0.10 vs. 0.81 AE 0.11), and this measurement was associated with HER-2 positive status (adjusted odds ratio [OR] = 654.4); however, similar results were not observed for the ADC measurement of SS-EPI (0.80 AE 0.10 vs. 0.78 AE 0.11 with P = 0.199 and adjusted OR = 0.21 with P = 0.464, respectively).

Editorial for “Intraobserver and Interobserver Reproducibility of Breast Diffusion‐Weighted Imaging Quantitative Parameters: Readout‐Segmented vs. Single‐Shot Echo‐Planar Imaging”

“…Overall image quality (image sharpness, geometric distortion, lesion conspicuity, visualization of anatomic structures) had better intraobserver and interobserver reproducibility with rs‐EPI than with ss‐EPI, which is in accordance with the literature 8 . The authors supported these results with a previous study explaining that rs‐EPI reduces blurring and distortion using a faster k‐space traversal in the readout direction in rs‐EPI 9 .…”

Development and validation of a point-based scoring system for predicting axillary lymph node metastasis and disease outcome in breast cancer using clinicopathological and multiparametric MRI features

“…Data between the ALN metastasis and non-ALN metastasis groups were compared with Student's t test, chi-squared test, or Kruskal–Wallis H test, if appropriate. In addition, the intraclass correlation coefficient (ICC) was used to assess the interobserver agreement of the DCE-MRI parameters and the ADC values between the two radiologists [ 26 , 27 ]. An ICC value between 0.61 and 0.80 indicates good agreement, while an ICC value ≥ 0.81 indicates excellent agreement [ 28 ].…”

“…An ICC value between 0.61 and 0.80 indicates good agreement, while an ICC value ≥ 0.81 indicates excellent agreement [ 28 ]. A receiver operating characteristic (ROC) curve was created to estimate the discriminating power of the models, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated [ 27 ]. The ROCs of the models were compared by using the DelLong test.…”

Early prediction of pathological complete response to neoadjuvant chemotherapy combining DCE-MRI and apparent diffusion coefficient values in breast Cancer

“…Menopausal status, baseline maximum tumor diameter, histological type, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor type 2 (HER2), Ki67%, molecular subtypes, clinical T/N stage, neoadjuvant treatment protocol, pathological response, quantitative and semiquantitative DCE-MRI parameters, and ADC values were recorded. Ki-67 ≥20% indicated high expression [18,19]. Premenopause refers to the whole reproductive period before menopause.…”