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Erschienen in:
29.04.2020 | Breast
Diffusion-weighted imaging or dynamic contrast-enhanced curve: a retrospective analysis of contrast-enhanced magnetic resonance imaging–based differential diagnoses of benign and malignant breast lesions
Erschienen in: European Radiology | Ausgabe 9/2020
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Objective
To compare the diagnostic performance of models based on a combination of contrast-enhanced (CE) magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) or time-intensity curves (TIC) in diagnosing malignancies of breast lesions.
Methods
A double-blind retrospective study was conducted in 328 patients (254 for training and the following 74 for validation) who underwent dynamic contrast–enhanced MRI (DCE-MRI) of the breast with pathological results. Two score models, the DWI model (apparent diffusion coefficient (ADC) + morphology + enhanced information) and the TIC model (TIC + morphology + enhanced information), were established with binary logistic regression for mass and non-mass enhancements (NMEs) in the training set. The sensitivity, specificity, and area under the curve (AUC) were compared between the two models (DWI model vs. TIC model); p < 0.05 was considered as statistically different. External validation was used.
Results
In the training set, the sensitivities, specificities, and AUCs of the DWI/TIC model were 95.2%/95.8%, 70.8%/47.9%, and 0.932/0.891 for masses, and 94.2%/90.4%, 47.4%/47.4%, and 0.798 (95% CI, 0.686–0.884)/0.802 (95% CI, 0.691–0.887) for NMEs, respectively. The AUC of the DWI model was significantly higher than that of the TIC model (p < 0.05) for masses. In the validation set, the AUCs of the DWI/TIC model were 0.896/0.861 for masses (p < 0.05) and 0.936/0.836 for NMEs (p > 0.05).
Conclusions
Combined with CE MRI, the DWI model was superior or equal to the TIC model in differentiating benign and malignant breast lesions.
Key Points
• Diffusion magnetic resonance imaging played an important role in the diagnosis of breast neoplasms.
• On the basis of contrast-enhanced MRI, the DWI model had significantly higher diagnostic ability than the TIC model in distinguishing benign and malignant masses.
• It would be reasonable to replace the time-consuming TIC with DWI for less scan time and similar diagnostic efficiency.