title: Multiparametric diffusion-weighted imaging in breast lesions: Association with pathologic diagnosis and prognostic factors.
abstract: To determine the utility of multiparametric diffusion-weighted imaging (DWI) including monoexponential (apparent diffusion coefficient [ADC]), biexponential (Df, Ds, and f), stretched-exponential (distributed diffusion coefficient [DDC] and α), and kurtosis (mean diffusivity [MD] and mean kurtosis [MK]) models in the differentiation and characterization of breast lesions, and assess their associations with prognostic factors in invasive breast cancer.
  
  
  
  This study included 101 patients (44 benign and 57 malignant lesions) who underwent 3T breast multi-b-value DWI. Diffusion model selection was investigated in benign and malignant lesions using the Akaike information criteria (AIC). Mann-Whitney U-test and receiver operating characteristic (ROC) curves were used for statistical analysis.
  
  
  
  Goodness-of-fit analysis showed that most benign lesion voxels (50.5%) were preferred by the kurtosis model, and most malignant lesion voxels (51.2%) by the stretched-exponential model. All diffusion measures showed significant differences between benign and malignant lesions (P < 0.05), and between in situ and invasive cancers (P < 0.05) except MD (P = 0.103). There were no significant differences in areas under the ROC curves (AUCs) between ADC and non-monoexponential diffusion parameters (P > 0.05), except Dfand α, whose AUCs were significantly lower than AUC of ADC for differentiating benign from malignant lesions (P = 0.03 and P < 0.01, respectively). In patients with invasive breast cancer, α was significantly correlated with tumor size (P = 0.007) and Ki-67 expression (P = 0.012), Dfwas significantly correlated with lymph node metastasis (P = 0.021) and Ki-67 expression (P = 0.042), and ADC, Ds, f, DDC, and MD were significantly correlated with estrogen receptor status (all P < 0.05).
  
  
  
  Multiparametric DWI shows relationships with pathologic outcomes and prognostic factors of breast lesions.
  
  
  
  3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:740-750.
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Shiteng
authors.initials: S
authors.lastname: Suo
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Fang
authors.initials: F
authors.lastname: Cheng
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Mengqiu
authors.initials: M
authors.lastname: Cao
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Jiwen
authors.initials: J
authors.lastname: Kang
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Mingyao
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Jia
authors.initials: J
authors.lastname: Hua
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Xiaolan
authors.initials: X
authors.lastname: Hua
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Lan
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lu
authors.affiliation: School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Jialin
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: breast; cancer; diffusion-weighted imaging; goodness of fit; magnetic resonance imaging