New lens on breast health: harnessing high-b-value synthetic diffusion-weighted imaging for breast lesion characterization.

IF 1.7 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Serap Karabiyik, Saime Ramadan, Emil Settarzade, Ali Ilker Filiz, Hatice Ozturkmen Akay
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引用次数: 0

Abstract

Purpose: This study aims to evaluate the diagnostic efficacy of synthetic diffusion-weighted imaging (sDWI) at various high b-values in distinguishing malignant from benign breast lesions and to compare its performance with that of conventional DWI (cDWI).

Methods: After the exclusion of 22 lesions, 63 women (age range, 24-99 years; mean age, 53.7 ± 15.1 years) with 68 suspicious breast lesions on ultrasound who underwent multiparametric breast magnetic resonance imaging before biopsy between January 2021 and April 2023 were included in this retrospective study. According to the pathological results, lesions were classified as malignant or benign. Volumetric mask images were defined. The lesion signal/normal breast signal ratio [relative signal intensity (rSI)] was measured on different diffusion-weighted images (cDWI at b = 800 and 1500 s/mm2; sDWI at b = 1500-5000 s/mm2), and lesion SI on apparent diffusion coefficient (ADC) 0-800 and ADC0-1500 maps (mADC) was calculated. The diagnostic performances of these parameters were evaluated using a receiver operating characteristic curve analysis and the DeLong test in both the mass and non-mass lesion groups.

Results: A total of 32 (47.06%) benign and 36 (52.94%) malignant lesions were identified. Malignant lesions exhibited significantly higher rSI values on cDWI800, cDWI1500, sDWI1500, sDWI2000, and sDWI3000 (P values: <0.001, <0.001, <0.001, <0.001, <0.001, 0.03) and lower mADC800 and mADC1500 values (P values: 0.01 and 0.03). In mass lesions, synthetic b1500 and conventional b1500 demonstrated diagnostic accuracy comparable with that of routine mADC800 and mADC1500. However, in non-mass lesions, high-b-value DWI maps (b ≥ 2000 s/mm2) significantly outperformed mADC and cDWI in differentiating malignant from benign lesions. The highest diagnostic accuracy in non-mass lesions was observed with rSIC4000 [area under the curve (AUC) = 0.87], whereas in mass lesions, rSIC1500 exhibited the highest diagnostic performance (AUC = 0.79).

Conclusion: The optimal b-value for DWI differs between mass and non-mass breast lesions, emphasizing the need for separate evaluation protocols. Although high-b-value sDWI provides limited added diagnostic value in mass lesions, it significantly improves malignancy detection in non-mass lesions, outperforming cDWI and ADC mapping.

Clinical significance: This study underscores the need for a tailored DWI protocol for optimal breast lesion characterization, particularly for non-mass lesions, where high-b-value synthetic imaging enhances diagnostic accuracy.

乳腺健康的新视角:利用高b值合成弥散加权成像进行乳腺病变表征。
目的:本研究旨在评价各种高b值合成弥散加权成像(sDWI)对乳腺良恶性病变的诊断价值,并与常规DWI (cDWI)的表现进行比较。方法:排除22个病变后,63例女性(年龄24 ~ 99岁;本研究纳入了2021年1月至2023年4月期间,平均年龄53.7±15.1岁,活检前行多参数乳腺磁共振成像的68例超声可疑乳腺病变患者。根据病理结果将病变分为恶性和良性。定义体积掩模图像。在不同的弥散加权图像上测量病变信号/正常乳腺信号之比[相对信号强度(rSI)] (cDWI在b = 800和1500 s/mm2;计算b = 1500 ~ 5000s /mm2时的sDWI,以及表观扩散系数(ADC) 0 ~ 800和adc0 ~ 1500图(mADC)上病变SI。在肿块组和非肿块组中,使用受试者工作特征曲线分析和DeLong试验来评估这些参数的诊断性能。结果:共检出良性病变32例(47.06%),恶性病变36例(52.94%)。恶性病变cDWI800、cDWI1500、sDWI1500、sDWI2000、sDWI3000的rSI值显著高于恶性病变(P值分别为0.01、0.03)。在肿块中,合成b1500和常规b1500的诊断准确性与常规mADC800和mADC1500相当。然而,在非肿块病变中,高b值DWI图(b≥2000 s/mm2)在区分良恶性病变方面明显优于mADC和cDWI。rSIC4000在非肿块性病变中的诊断准确率最高[曲线下面积(AUC) = 0.87],而在肿块性病变中,rSIC1500的诊断准确率最高(AUC = 0.79)。结论:乳腺肿块性病变与非肿块性病变DWI的最佳b值不同,强调需要单独的评估方案。虽然高b值sDWI对肿块性病变的附加诊断价值有限,但其对非肿块性病变的恶性检出率显著提高,优于cDWI和ADC制图。临床意义:本研究强调了定制DWI方案的必要性,以获得最佳的乳腺病变特征,特别是对于非肿块性病变,高b值合成成像可提高诊断准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnostic and interventional radiology
Diagnostic and interventional radiology Medicine-Radiology, Nuclear Medicine and Imaging
自引率
4.80%
发文量
0
期刊介绍: Diagnostic and Interventional Radiology (Diagn Interv Radiol) is the open access, online-only official publication of Turkish Society of Radiology. It is published bimonthly and the journal’s publication language is English. The journal is a medium for original articles, reviews, pictorial essays, technical notes related to all fields of diagnostic and interventional radiology.
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