China Oncology ›› 2017, Vol. 27 ›› Issue (10): 795-800.

### Differentiation of benign and malignant breast lesions: a comparative study of intravoxel incoherent motion and quantitative dynamic contrast enhanced-magnetic resonance imaging

SUN Ruihong1, JIANG Zhaoxia2, MENG Fanhua1, YIN Huabin1, TANG Wenlin3, SHEN Lijuan1,2

1. 1. Department of Radiology, the Fifth People’s Hospital of Shanghai, Fudan University, Department of Gynecology and Obstetrics, Shanghai Medical College, Fudan University, Shanghai 200240, China; 2. Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3. Siemens Healthcare, Shanghai 201600, China
• Online:2017-10-30 Published:2017-12-05
• Contact: SHEN Lijuan E-mail: 13817959783@163.com

Abstract: Background and purpose: Breast cancer is one of the most common malignant tumors among women. Intravoxel incoherent motion (IVIM) is a functional imaging technique based on the theory of biexponential model developed in recent years, which can exhibit diffusion and perfusion effects. This study aimed to investigate the reproducibility of IVIM parameters and the value in the diagnosis of breast lesions, comparing with quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters, to explore whether correlations exist among perfusion parameters. Methods: A prospective study was performed in 56 patients with pathologically confirmed benign lesions (n=30), malignant tumors (n=31). All patients underwent DCE-MRI and IVIM imaging. Two radiologists measured the images independently to obtain the parameters from IVIM (D, D*, f ) and DCE-MRI (Ktrans, Kep, Ve). The data consistency between two observers was calculated with intraclass correlation coefficient (ICC). All parameters were statistically compared between benign lesions and malignant tumors using independent sample t test. The receiver operating characteristic (ROC) curve was used to evaluate the ability of the parameters in differentiation of benign and malignant breast lesions. Pearson correlation analyses were used among the IVIM and DCE-MRI parameters. Results: The agreement between 2 radiologists was good for all parameters (ICC≥0.730, P<0.05). D value was significantly lower in malignant lesions than in benign lesions, while the f , Ktrans and Kep values were higher than those in benign lesions (P<0.05). The D* and Ve values showed no differences between benign and malignant breast lesions (P>0.05). The areas under the ROC curve for D, f, Ktrans and Kep were 0.896, 0.677, 0.796 and 0.847, respectively. There was no significant difference in the area under ROC curve between D and Ktrans, neither between the D and Kep (P>0.05). The D value showed higher specificity (86.67%) with the threshold of 1.07×10-3 mm2/s. The Kep value showed higher sensitivity (98.36%) with the threshold of 0.54/min. The f value exhibited a positive correlation with Ktrans and Kep value with r of 0.373 and 0.360 (P<0.05), respectively. D* was also poorly correlated positively with Ktrans with an r of 0.294. Conclusion: The IVIM parameters showed good reproducibility between different radiologists. Both IVIM and DCE-MRI could be helpful in differentiating between benign and malignant breast lesions with positive correlation of the perfusion fraction.