title: Intravoxel incoherent motion diffusion-weighted imaging as an adjunct to dynamic contrast-enhanced MRI to improve accuracy of the differential diagnosis of benign and malignant breast lesions.
abstract: To investigate the value of use of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) as an adjunct to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to distinguish benign from malignant breast lesions.
  
  
  
  Retrospective analysis of data pertaining to 117 patients with breast lesions who underwent DCE-MRI and IVIM-DWI examination with 3.0T MRI was conducted. A total of 128 lesions were pathologically confirmed (47 benign and 81 malignant). Between-group differences in DCE-MRI parameters (Morphology, enhancement pattern, maximum slope of increase (MSI) and time-signal curve (TIC) type) and IVIM-DWI parameters (f value, D value and D* value) were assessed. Multivariate logistic regression was performed to identify variables that distinguished benign from malignant breast lesions. The diagnostic performance of DCE-MRI and DCE-MRI plus IVIM-DWI, to distinguish benign from malignant breast lesions, was evaluated using pathology results as the gold standard.
  
  
  
  Lesion morphology, MSI, and TIC type (P<0.05), but not the enhancement pattern (P>0.05), were significantly different between the benign and malignant groups. The f (8.53±2.14) and D* (7.64±2.07) values in the malignant group were significantly higher than those in the benign group (7.68±1.97 and 6.83±2.13, respectively), while the D value (0.99±0.22) was significantly lower than that (1.34±0.17) in the benign group (P<0.05 for all). On logistic regression analysis, the sensitivity, specificity and accuracy of DCE-MRI were 90.1%, 70.2% and 82.8% respectively; the corresponding figures for the combination of IVIM-DWI and DCE-MRI were 88.8%, 85.1%, and 87.5%respectively.
  
  
  
  IVIM-DWI method as an adjunct to DCE-MRI can improve the specificity and accuracy in differential diagnosis of benign and malignant lesions of breast.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, 250021, China; Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Dejing
authors.initials: D
authors.lastname: Ma
authors.affiliation: Respiratory department, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Lu
authors.affiliation: Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Xuexue
authors.initials: X
authors.lastname: Zou
authors.affiliation: Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
authors.forename: Dongjing
authors.initials: D
authors.lastname: Qin
authors.affiliation: Medical Imaging Research Institute, Binzhou Medical University, Yantai, Shandong, 264003, China. Electronic address: binwang001@aliyun.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009038:Motion; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Breast lesions; Diffusion-weighted imaging; Dynamic contrast-enhanced magnetic resonance imaging; Intravoxel incoherent motion