Identification of the Benignity and Malignancy of BI-RADS 4 Breast Lesions Based on a Combined Quantitative Model of Dynamic Contrast-Enhanced MRI and Intravoxel Incoherent Motion
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. MRI Image Acquisition
2.3. Image Analysis
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Consistency Test
3.3. DWI and DCE–MRI Quantitative Parameters in Benign and Malignant Breast Lesions
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Parameter | Number of Patients |
---|---|
Benign leasions | 20 |
Mean age (years) | 40.8 (26–61) |
Histological restult | |
Fibroadenoma | 9 |
Granulomatous mastitis | 3 |
Adenomatosis | 3 |
Phyllodes tumor (benign) | 3 |
Fibrocystic change | 2 |
Malignant leasions | 80 |
Mean age (years) | 49.0 (29–73) |
Histological restult | |
Ductal carcinoma in situ | 8 |
Invasive ductal carcinoma | 62 |
Invasive lobular carcinoma | 5 |
Mucinous carcinoma | 3 |
Paget’s disease | 1 |
Metaplastic carcinoma | 1 |
Parameter | ICC | Parameter | ICC | Parameter | ICC |
---|---|---|---|---|---|
Ktrans_min | 0.875 | Ve_min | 0.844 | D*_min | 0.419 |
Ktrans_max | 0.865 | Ve_max | 0.876 | D*_max | 0.867 |
Ktrans_median | 0.951 | Ve_median | 0.991 | f_mean | 0.913 |
Ktrans_mean | 0.960 | Ve_mean | 0.981 | f_min | 0.865 |
Kep_min | 0.701 | D_mean | 0.913 | f_max | 0.821 |
Kep_max | 0.946 | D_min | 0.911 | ADC_mean | 0.999 |
Kep_median | 0.906 | D_max | 0.916 | ADC_min | 0.997 |
Kep_mean | 0.919 | D*_mean | 0.954 | ADC_max | 0.997 |
Parameter | Benign Lesions (n = 20) | Malignant Lesions (n = 80) | p Value |
---|---|---|---|
D_mean (×10−3 mm2/s) | 1.41 ± 0.27 | 1.07 ± 0.26 | <0.001 # |
D_min (×10−3 mm2/s) | 1.21 (1.02,1.60) | 0.93 (0.74,1.11) | <0.001 |
D_max (×10−3 mm2/s) | 1.51 ± 0.25 | 1.18 ± 0.26 | <0.001 # |
D*_mean (×10−3 mm2/s) | 27.05 (10.98,78.65) | 15.20 (8.37,28.05) | 0.032 |
D*_min (×10−3 mm2/s) | 9.88 (5.70,31.33) | 7.97 (4.87,13.38) | 0.289 |
D*_max (×10−3 mm2/s) | 44.65 (21.05,29.38) | 22.50 (13.20,46.30) | 0.025 |
f_mean (%) | 11.00 (5.17,15.48) | 13.70 (11.20,19.70) | 0.035 |
f_min (%) | 7.44 (2.89,11.20) | 10.25 (7.94,12.55) | 0.009 |
f_max (%) | 16.90 (9.59,24.48) | 17.60 (14.53,29.15) | 0.252 |
ADC_mean (×10−3 mm2/s) | 1.52 ± 0.25 | 1.28 ± 0.25 | 0.001 # |
ADC_min (×10−3 mm2/s) | 1.46 ± 0.26 | 1.22 ± 0.25 | 0.001 # |
ADC_max (×10−3 mm2/s) | 1.58 ± 0.25 | 1.35 ± 0.25 | 0.001 # |
Ktrans_min (min−1) | 0.06 (0.03,0.09) | 0.06 (0.03,0.18) | 0.558 |
Ktrans_max (min−1) | 0.42 (0.15,1.71) | 1.02 (0.46,2.38) | 0.011 |
Ktrans_median (min−1) | 0.19 (0.09,0.60) | 0.35 (0.15,0.75) | 0.095 |
Ktrans_mean (min−1) | 0.20 (0.09,0.66) | 0.39 (0.16,0.83) | 0.064 |
Kep_min (min−1) | 0.01 (0.00,0.06) | 0.000 (0.00,0.12) | 0.571 |
Kep_max (min−1) | 0.75 (0.46,0.97) | 1.80 (1.15,3.07) | <0.001 |
Kep_median (min−1) | 0.28 (0.19,0.49) | 0.52 (0.37,0.75) | 0.001 |
Kep_mean (min−1) | 0.31 (0.19,0.50) | 0.61 (0.39,0.82) | <0.001 |
Ve_min | 0.11 (0.00,0.32) | 0.00 (0.00,0.28) | 0.222 |
Ve_max | 1.00 (1.00,1.00) | 1.00 (1.00,1.00) | 0.964 |
Ve_median | 0.75 (0.38,1.00) | 0.68 (0.33,0.98) | 0.632 |
Ve_mean | 0.73 (0.41,0.93) | 0.68 (0.38,0.87) | 0.477 |
Model | Variables | AUC | Standard Error | 95% Confidence Interval | Accuracy (%) | Sensitivity (%) | Specificity (%) | |
---|---|---|---|---|---|---|---|---|
Lower Bound | Upper Bound | |||||||
model_ADC | ADC_min | 0.768 | 0.063 | 0.672 | 0.846 | 0.789 | 75.00 | 75.00 |
model_IVIM | D_mean | 0.826 | 0.044 | 0.737 | 0.894 | 0.820 | 72.50 | 80.00 |
model_DCE | Kep_max | 0.823 | 0.056 | 0.734 | 0.892 | 0.793 | 78.75 | 85.00 |
model_DCE+ADC | Kep_max, ADC_min | 0.852 | 0.049 | 0.768 | 0.915 | 0.789 | 86.25 | 75.00 |
model_DCE+IVIM | Kep_max, D_mean | 0.903 | 0.037 | 0.828 | 0.953 | 0.789 | 87.50 | 85.00 |
Model | Standard Error | p Value |
---|---|---|
model_DCE+IVIM vs. model_IVIM | 0.036 | 0.033 |
model_DCE+IVIM vs. model_ADC | 0.055 | 0.014 |
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Xu, W.; Zheng, B.; Li, H. Identification of the Benignity and Malignancy of BI-RADS 4 Breast Lesions Based on a Combined Quantitative Model of Dynamic Contrast-Enhanced MRI and Intravoxel Incoherent Motion. Tomography 2022, 8, 2676-2686. https://doi.org/10.3390/tomography8060223
Xu W, Zheng B, Li H. Identification of the Benignity and Malignancy of BI-RADS 4 Breast Lesions Based on a Combined Quantitative Model of Dynamic Contrast-Enhanced MRI and Intravoxel Incoherent Motion. Tomography. 2022; 8(6):2676-2686. https://doi.org/10.3390/tomography8060223
Chicago/Turabian StyleXu, Wenjuan, Bingjie Zheng, and Hailiang Li. 2022. "Identification of the Benignity and Malignancy of BI-RADS 4 Breast Lesions Based on a Combined Quantitative Model of Dynamic Contrast-Enhanced MRI and Intravoxel Incoherent Motion" Tomography 8, no. 6: 2676-2686. https://doi.org/10.3390/tomography8060223