Use of diffusion kurtosis imaging and quantitative dynamic contrast‐enhanced MRI for the differentiation of breast tumors

Li, Ting; Yu, Tao; Li, Lyu; Lu, Lunbo; Zhuo, Yaoyao; Lian, Jingge; Xiong, Yun; Kong, Dexing; Li, Kangan

doi:10.1002/jmri.26059

Cited by 42 publications

(35 citation statements)

References 27 publications

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“…In addition, another study showed that compared with traditional DWI, diffusion kurtosis imaging (DKI) can better distinguish between benign and malignant breast lesions. Also, this article showed that Kep performed better than Ktrans [46]. However, our results suggested that Ktrans value is the best one in predicting prognosis of breast cancer.…”

Section: Discussionmentioning

confidence: 83%

Role of perfusion parameters on DCE-MRI and ADC values on DWMRI for invasive ductal carcinoma at 3.0 Tesla

Liu

Wang

2018

World J Surg Onc

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BackgroundThe value of apparent diffusion coefficient (ADC) values and quantitative parameters (Ktrans, Kep, Ve) in detecting prognostic factor at 3.0 Tesla remains unclear, especially in predicting prognosis of breast cancer.MethodsA total of 151 patients with IDC underwent breast DCE-MRI and DWI-MRI at 3.0 Tesla following surgery. The ADC values were acquired with b values of 0 and 1000 s/mm2. The relationship between ADC values or DCE-MRI quantitative parameters and size, histologic grade (HG), lymph node metastasis (LNM), ER, PR, and Ki67 was evaluated. The predictive values of ADC, Ktrans, Kep, and Ve to prognosis of IDC were assessed.ResultsADC value was positively related to size (P = 0.04) and HER2 (P = 0.046) expression and negatively related to ER (P = 0.012) and PR (P < 0.001) expression. Ktrans value has positive correlation with size (P < 0.001), HG (P < 0.001), LNM (P < 0.001), HER2 (P = 0.007), and Ki67 (P < 0.001) expression and negative correlation with ER (P < 0.001) and PR (P < 0.001) expression. Kep value was positively related to size (P < 0.001) and negatively related to ER (P < 0.001) and PR (P < 0.001) expression. Ve value was negatively related to HER2 expression (P = 0.004). The Cox hazard ratio (HR) of ADC, Ktrans, Kep, and Ve values on survival was 5.26 (P = 0.093), 1.081 (P = 0.002), 1.006 (P = 0.941), and 0.883 (P = 0.926), respectively.ConclusionsKtrans value was a best predictive indicator of HG, LNM, ER, PR, and Ki67 expression, and ADC value was the best predictive indicator of HER2. Preoperative use of the 3.0 Tesla could provide important information to determine the optimal treatment plan.

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Section: Discussionmentioning

confidence: 83%

Role of perfusion parameters on DCE-MRI and ADC values on DWMRI for invasive ductal carcinoma at 3.0 Tesla

Liu

Wang

2018

World J Surg Onc

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“…Further, due to the limited acquisition time, the number of b-values as well as the choice of the highest b value may not be optimal for DKI analysis 36 . For example, in other studies, higher b values and a larger number of them were used 14,16,17 . Nonetheless, the primary objective of this study was to create a shortened DKI protocol applicable in the clinical routine.…”

Section: Discussionmentioning

confidence: 99%

“…While the acquired DWI data is mostly assessed visually in a clinical setting, quantitative multiparametric analysis is gaining increasing attention since it may improve standardization and the still limited specificity of lesion characterization. In this context, diffusion kurtosis imaging (DKI) has been recently introduced in breast DWI analysis yielding a second quantitative parameter, the kurtosis, in addition to the diffusion coefficient [12][13][14][15][16][17][18][19] .…”

Section: Influence Of Residual Fat Signal On Diffusion Kurtosis Mri Omentioning

confidence: 99%

Influence of residual fat signal on diffusion kurtosis MRI of suspicious mammography findings

Mlynarska-Bujny

Bickelhaupt

Laun

et al. 2020

Sci Rep

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Using the accompanying information about the index lesion localization from the X-ray screening report and T2-weighted imaging, ROIs were manually defined on the b = 1500 s/mm 2 images or-if not clearly visible for this highest diffusion weighting-on b = 750 s/mm 2 , while trying to minimize partial volume effects by using the inner border of the lesion. Additionally, for each patient, a second ROI was drawn on the DWI dataset in an area containing fatty tissue as determined in concordance with the T2-weighted imaging. The oval-shaped fatty tissue area was usually drawn on the contralateral breast, in a mirrored position of the lesion to provide comparable distance to the surface of the coil. Calculation of quantitative parameters. The following diffusion and kurtosis evaluation approaches were evaluated to investigate the influence of fat contamination. D i (i = 1. .. 5) and K i (i = 2. .. 5) denote the apparent diffusion coefficient and the apparent kurtosis coefficient obtained by the respective methods. Method 1. The standard apparent diffusion coefficient, termed D 1 here, was obtained using the mono-exponential fit function with the two fitting parameters D 1 and S 0 , which corresponds to the signal without diffusion weighting. S(b) is the mean signal intensity in the respective lesion ROI. Method 2. For the standard kurtosis fitting approach, the following equation was used: with the modified apparent diffusion coefficient D 2 , the apparent kurtosis coefficient K 2 , and S 0 as free parameters in the fit. Method 3. This method accounts for possible fat signal contamination due to chemical shift in phase encoding direction, which may transfer unsuppressed fat signal to the lesion ROI. Therefore, a constant signal level was added to Eq. (2), which was determined in fatty tissue:

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“…For a rigorous estimation, a protocol including at least 15 diffusion weighting directions and 2 non-null b-values would be required [40]. Furthermore, although we applied a high b value of 3000 based on earlier studies utilizing DKI analysis [18,19,41], this does not necessarily suggest that the b values used were optimal for accurate DKI analysis. These factors may have further affected the performance of DKI analysis in our study.…”

Section: Discussionmentioning

confidence: 99%

Diffusional kurtosis imaging for differentiation of additional suspicious lesions on preoperative breast MRI of patients with known breast cancer

Park

Kim

et al. 2019

Magnetic Resonance Imaging

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Purpose: To investigate the potential of diffusional kurtosis imaging (DKI) and conventional diffusion-weighted imaging (DWI) in the evaluation of additional suspicious lesions at preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer. Materials and methods: Fifty-three additional suspicious lesions in 45 patients with breast cancer, which were detected on preoperative breast MRI, were examined with a 3-T MR system. DKI and DWI data were obtained using a spin-echo single-shot echo-planar imaging sequence with b-values of 0, 50, 600, 1000, and 3000 s/mm 2. Histogram parameters (mean, standard deviation, minimum, maximum, 10th, 25th, 50th, 75th, 90th percentiles, kurtosis, skewness and entropy) of ADC from DWI and diffusivity (D), kurtosis (K) from DKI were calculated after postprocessing. Parameters were compared between benign vs. ductal carcinoma in situ (DCIS) vs. invasive breast lesions and diagnostic performances were evaluated by receiver operating characteristic (ROC) analysis. Correlation between the mean values of D and K was analyzed according to lesion type. Results: Multiple histogram parameters of D (mean, 25th, 50th percentile, 75th percentile, and entropy) differed between benign and invasive breast lesions (all P < 0.005), but none differed between benign vs. DCIS. D-90th percentile differed between DCIS vs. invasive cancer (P = 0.040). K-10th percentile differed between benign vs. DCIS (P = 0.015). ADC-75th percentile differed between benign vs. invasive cancer and ADC-75th percentile, ADC-90th percentile differed between DCIS vs. invasive cancer, respectively (all P < 0.005). ROC curve analysis showed high specificity for discrimination between benign and invasive cancer. D-mean and Kmean showed strong correlation in benign (r s = −0.813) and invasive lesions (r s = −0.853), but no significant correlation in DCIS.

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Use of diffusion kurtosis imaging and quantitative dynamic contrast‐enhanced MRI for the differentiation of breast tumors

Abstract: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1358-1366.

Cited by 42 publications

References 27 publications

Role of perfusion parameters on DCE-MRI and ADC values on DWMRI for invasive ductal carcinoma at 3.0 Tesla

Role of perfusion parameters on DCE-MRI and ADC values on DWMRI for invasive ductal carcinoma at 3.0 Tesla

Influence of residual fat signal on diffusion kurtosis MRI of suspicious mammography findings

Diffusional kurtosis imaging for differentiation of additional suspicious lesions on preoperative breast MRI of patients with known breast cancer

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