The dynamic contrast-enhanced MR imaging of breast cancer: the correlation between mono-exponential DWI parameters and semi-quantitative TIC characteristics

Abstract

Background To investigate the relationship between mono-exponential diffusion- weighted imaging (DWI) parameters and time-intensity curve (TIC) characteristics generated from dynamic contrast-enhanced (DCE) MRI of breast cancer. Materials and Methods A total of 108 patients with breast cancer were prospectively enrolled in this study. All patients underwent DWI and DCE-MRI examination. Patients were divided into untypical TIC and untypical TIC groups; untypical TIC pattern was defined as a wash-in/plateau curve, and the typical TIC pattern of breast cancer as a wash-out curve. The relationships between DWI parameters and semi-quantitative TIC characteristics were investigated by using multivariate logistic regression analysis. Results The BI-RADS grade and the incidence of lymph node metastasis were higher in the typical TIC group (all P < 0.05). The ADCmean and ADCmin values were lower in the typical TIC group than in the untypical TIC group (all P < 0.05). There was a significantly negative correlation between ADCmean or ADCmin value and SIslope2 (r=-0.535,-0.514; P = 0.02, 0.04). According to logistic regression analysis, micro-vessel density (MVD), tumor stroma ratio (TSR), ADCmin, histological grading, and ADCmean were independently correlated with TIC patterns. Conclusion The water diffusion restriction reflected by DWI parameters may contribute to the TIC characteristics at the late phase after enhancement, which provides theoretical guidance for the diagnosis of breast cancer based on a combination of DWI and TIC characteristics.

Impact of DWI and ADC values in Ovarian-Adnexal Reporting and Data System (O-RADS) MRI score

“…Actually, a recent study showed that the type II curve (intermediate risk of malignancy) was present not only in malignant lesions (50%) but also in 29.3% of benign lesions [10]. The overlap of TIC patterns between benign and malignant diseases in clinical settings may occur, resulting in inaccurate diagnosis [11].…”