The Application Study Of Intravoxel Incoherent Motion Diffusion-weighted Imaging In Breast Lesions

Purpose1. To estimate the reproducibility of intravoxel incoherent motion diffusion-weightedimaging (IVIM-DWI) in breast.2. To investigating the value of parameters derived by IVIM-DWI in differentiationbreast lesions as malignant or benign. Meanwhile, characterizing whether acorrelation exists between the parameters and immunohistochemical index in breastductal carcinoma.Methods1. Sixty-seven Patients underwent MRI at1.5T and sixty subjects hadpathology-proven diagnosis. The first twenty cases repeated IVIM-DWI scan within24-48hours. All lesions were identified using the parameters：Standard ADC, SlowADC, Fast ADC and Fraction.2. The repeated parameters derived by IVIM-DWI were compared by using the pairedt test. Reproducibility of parameters measurement on repeated acquisitions weredetermined by using intraclass correlation coefficients (ICCs) and95%Bland-Altmanlimits of agreement.3. Mean Standard ADC, Slow ADC, Fast ADC and Fraction of malignant, benign andnormal glandular tissues were analyzed.4. The differences between Standard ADC and Slow ADC were analyzed.5. Meanwhile, correlations between parameters and expression of ER, PR, Ki-67and C-erbB-2were calculated. The differences between atypical hyperplasia andnon-atypical hyperplasia were statistic as well as.Results1. There were no significant differences in the parameters between repeated acquisitions (P>0.05), all the ICCs were beyond0.8.2. Mean Standard ADC and Slow ADC was lower in malignant tumors than that inbenign lesions. Mean Standard ADC and Slow ADC was higher in normal glandularthan that in benign lesions. There were dominant differences between malignant andbenign lesions, malignant lesions and normal glandular tissues, benign lesions andnormal glandular tissues in mean Standard ADC and Slow ADC. Mean Fast ADC andFraction was higher in malignant tumors than that in benign lesions. Mean Fast ADCand Fraction was lower in normal glandular tissues than that in benign lesions. Therewere significant differences between malignant and benign lesions, malignant lesionsand normal glandular tissues in mean Fraction. Mean Fast ADC showed notsignificant differences between malignant and benign lesions, malignant lesions andnormal glandular tissues but benign lesions and normal glandular.3. There were essential differences between mean Standard ADC and mean SlowADC in all groups. Area under the ROC of Slow ADC was bigger than that ofStandard ADC.4. Furthermore, there were significant differences between the tumor with ERnegativity than with ER positivity in mean Standard ADC, Slow ADC and Fraction. Itwas essential differences between the tumor with PR negativity than with PRpositivity in mean Slow ADC.5. There were statistic differences between atypical hyperplasia and non-atypicalhyperplasia in mean Standard ADC, Slow ADC.Conclusion1. The measurements obtained with IVIM-MRI of the breast are mostly reproducibleand valid.2. IVIM-MRI has potential role in estimating the benign and malignant breastlesions.3. Perfusion fraction was non-negligible in the DWI. Using IVIM-DWI increasesthe sensitivity of differentiation of malignant lesions from benign tissues.4. IVIM-DWI was relative to part of immunohistochemical index in breast ductal carcinoma.