Abstract
PurposeDynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is increasingly used for breast cancer diagnosis as supplementary to conventional imaging techniques. Combining of diffusion-weighted imaging (DWI) of morphology and kinetic features from DCE-MRI to improve the discrimination power of malignant from benign breast masses is rarely reported.Materials and MethodsThe study comprised of 234 female patients with 85 benign and 149 malignant lesions. Four distinct groups of features, coupling with pathological tests, were estimated to comprehensively characterize the pictorial properties of each lesion, which was obtained by a semi-automated segmentation method. Classical machine learning scheme including feature subset selection and various classification schemes were employed to build prognostic model, which served as a foundation for evaluating the combined effects of the multi-sided features for predicting of the types of lesions. Various measurements including cross validation and receiver operating characteristics were used to quantify the diagnostic performances of each feature as well as their combination.ResultsSeven features were all found to be statistically different between the malignant and the benign groups and their combination has achieved the highest classification accuracy. The seven features include one pathological variable of age, one morphological variable of slope, three texture features of entropy, inverse difference and information correlation, one kinetic feature of SER and one DWI feature of apparent diffusion coefficient (ADC). Together with the selected diagnostic features, various classical classification schemes were used to test their discrimination power through cross validation scheme. The averaged measurements of sensitivity, specificity, AUC and accuracy are 0.85, 0.89, 90.9% and 0.93, respectively.ConclusionMulti-sided variables which characterize the morphological, kinetic, pathological properties and DWI measurement of ADC can dramatically improve the discriminatory power of breast lesions.
Highlights
The development of noninvasive methods of tissue characterization that could be applied early in the course of diagnosis to assess risk and to guild subsequent treatment would allow clinicians to tailor therapy on an individual
Multi-sided variables which characterize the morphological, kinetic, pathological properties and diffusion-weighted imaging (DWI) measurement of apparent diffusion coefficient (ADC) can dramatically improve the discriminatory power of breast lesions
Enrollment of the lesions abided by a strict inclusion criteria: (a) MR imaging was performed on a 1.5 T superconductive magnetic system (GE, Signa, HDx), with a bilateral, dedicated four-channel phased-array breast coil in its prone position.; (b) both DCE-MR imaging and DW MR imaging sequences were performed; (c) diagnosis was confirmed following a pathological analysis after core-needle biopsy or surgical excision (248 lesions), or lesion stability was confirmed at a minimum follow-up of 2 years (27 lesions); (d) lesions were presented as a mass according to the BIRADS magnetic resonance imaging (MRI) lexicon; and (e) patients had not had a biopsy or received therapy before MR examination
Summary
The development of noninvasive methods of tissue characterization that could be applied early in the course of diagnosis to assess risk and to guild subsequent treatment would allow clinicians to tailor therapy on an individual. More specialized methods, including dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted magnetic resonance imaging (DW-MRI), have advanced to the point where they provide quantitative measurements of tissue properties that are highly related to the assessing of tumor progression and/or responses [1,2,5,6,7]. Recent studies [8,9,10,11,12,13] found that the ADC is significantly lower in malignant tumors than in benign breast lesions or normal tissue in DW MRI. This special observation is mainly due to a high cell density, caused by an increased restriction of the extracellular matrix and an increased fraction of the signal from intracellular water [8,11,14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
