Abstract
BackgroundThe present study aims to investigate the role of histogram analysis of intravoxel incoherent motion (IVIM) in the differential diagnosis of benign and malignant breast lesions.MethodsThe magnetic resonance imaging and clinical data of 55 patients (63 lesions) were retrospectively analyzed. The multi-b-valued diffusion-weighted imaging image was processed using the MADC software to obtain the gray-scaled maps of apparent diffusion coefficient (ADC)-slow, ADC-fast and f. The MaZda software was used to extract the histogram metrics of these maps. Combined with the conventional sequence images, the region of interest (ROI) was manually drawn along the edge of the lesion at the maximum level of the gray-scale image, and the difference of the data was analyzed between the benign and malignant breast lesions.ResultsThere were 29 patients with 37 benign lesions, which included 23 fibroadenomas, 6 adenosis, 1 breast cysts, 4 intraductal papillomas, and 3 inflammations of breast. Furthermore, 26 malignant lesions in 26 patients, which included 20 non-specific invasive ductal carcinomas, 5 intraductal carcinomas and 1 patient with squamous cell carcinoma. The ADC-slow (mean and the 50th percentile) and f (minimum, mean, kurtosis, the 10th percentile and 50th percentile) of these malignant breast lesions were significantly lower than those of benign lesions (P < 0.05), while ADC-fast (kurtosis) and f (variance, skewness) of these malignant breast lesions were significantly higher than those of benign lesions (P < 0.05).ConclusionThe histogram analysis of ADC-slow (mean and the 50th percentile), ADC-fast (kurtosis) and f (minimum, mean, kurtosis, the 10th percentile and 50th percentile. Variance, skewness) can provide a more objective and accurate basis for the differential diagnosis of benign and malignant breast lesions.
Highlights
The present study aims to investigate the role of histogram analysis of intravoxel incoherent motion (IVIM) in the differential diagnosis of benign and malignant breast lesions
Punch biopsy remains the gold standard [3] for the diagnosis of breast cancer, some studies have shown that only 53.1% of patients are diagnosed with breast cancer by punch biopsy, indicating that there are some defects and missed diagnoses in the diagnosis of breast cancer [4]
Patient criteria for inclusion: (1) patients who completed the T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), T1WI dynamic enhancement scan and diffusion-weighted imaging (DWI); (2) within two weeks of the completion of the scan, an operation puncture or pathological puncture was required to confirm the pathological results; (3) no treatment was performed before the scan; (4) the scanning image was of good quality, without obvious motion artifacts
Summary
The present study aims to investigate the role of histogram analysis of intravoxel incoherent motion (IVIM) in the differential diagnosis of benign and malignant breast lesions. The incidence of breast cancer is continuously increasing and tends to occur more in younger patients [1]. The significance of imaging in the diagnosis of breast cancer is growing. Due to its high soft-tissue resolution, magnetic resonance imaging (MRI) has increasingly been used in the screening and diagnosis of breast lesions [6]. There is some overlap in the examination of benign and malignant breast lesions by MRI. Breast cancer shows a high signal intensity on diffusionweighted imaging (DWI), and some benign breast lesions show a high signal intensity, which limits the clinical application of MRI [7]
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