Application of whole-lesion histogram analysis of pharmacokinetic parameters in dynamic contrast-enhanced MRI of breast lesions with the CAIPIRINHA-Dixon-TWIST-VIBE technique
Application of whole-lesion histogram analysis of pharmacokinetic parameters in dynamic contrast-enhanced MRI of breast lesions with the CAIPIRINHA-Dixon-TWIST-VIBE technique
复制标题
CAIPIRINHA-Dixon-TWIST-VIBE技术全病灶药代动力学参数直方图分析在乳腺病灶动态增强MRI中的应用
DOI：
10.1002/jmri.25762
复制
发表时间：
2018-01-01
影响因子：
4.4
通讯作者：
Xia, Liming
中科院分区：
文献类型：
--
作者：
Li, Zhiwei;Ai, Tao;Xia, Liming
目的探讨全病灶直方图分析法在动态增强磁共振成像（DCE-MRI）鉴别乳腺良恶性病变中的应用。患者在3 T下使用原型CAIPIRINHA-Dixon-TWIST-VIBE（CDT-VIBE）序列进行动态乳腺MRI，随后进行手术或活检。然后基于整个病变计算血浆和氚之间的药剂流入速率（K-transs）、氚和血浆之间的药剂流出速率（K-ep）、每单位体积组织的血管外空间体积（v（e）），包括平均值、第25/50/75/90次斜率、偏度和峰度。结果恶性乳腺病变的K-transs、K-ep均数、25/50/75/90阶次均数均显著高于良性乳腺病变（P均<0.05），v（e）均显著低于良性乳腺病变（P均< 0.05），v（e）偏度显著高于良性乳腺病变（P均< 0.05）。乳腺良恶性病变的峰度值差异无统计学意义（均P > 0.05）。K-transs的第90百分位数、K-ep的第90百分位数和v（e）的第50百分位数显示了DCE-MRI得出的每个药代动力学参数的ROC曲线下面积（AUC）最大。第90百分位数的K-ep达到了最高的AUC值（0.927）之间的所有直方图派生value. ConclusionWhole病变直方图分析的药代动力学参数，可以提高诊断准确性乳腺DCE-MRI与CDT-VIBE技术。K-ep第90百分位数可能是鉴别乳腺良恶性病变的最佳指标。证据等级：4技术有效性阶段：2 J. Magn. Reson。影像学2018;47：91-96.
PurposeTo investigate the application of whole-lesion histogram analysis of pharmacokinetic parameters for differentiating malignant from benign breast lesions on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Materials and MethodsIn all, 92 women with 97 breast lesions (26 benign and 71 malignant lesions) were enrolled in this study. Patients underwent dynamic breast MRI at 3T using a prototypical CAIPIRINHA-Dixon-TWIST-VIBE (CDT-VIBE) sequence and a subsequent surgery or biopsy. Inflow rate of the agent between plasma and interstitium (K-trans), outflow rate of agent between interstitium and plasma (K-ep), extravascular space volume per unit volume of tissue (v(e)) including mean value, 25th/50th/75th/90th percentiles, skewness, and kurtosis were then calculated based on the whole lesion. A single-sample Kolmogorov-Smirnov test, paired t-test, and receiver operating characteristic curve (ROC) analysis were used for statistical analysis.ResultsMalignant breast lesions had significantly higher K-trans, K-ep, and lower v(e) in mean values, 25th/50th/75th/90th percentiles, and significantly higher skewness of v(e) than benign breast lesions (all P < 0.05). There was no significant difference in kurtosis values between malignant and benign breast lesions (all P > 0.05). The 90th percentile of K-trans, the 90th percentile of K-ep, and the 50th percentile of v(e) showed the greatest areas under the ROC curve (AUC) for each pharmacokinetic parameter derived from DCE-MRI. The 90th percentile of K-ep achieved the highest AUC value (0.927) among all histogram-derived values.ConclusionThe whole-lesion histogram analysis of pharmacokinetic parameters can improve the diagnostic accuracy of breast DCE-MRI with the CDT-VIBE technique. The 90th percentile of K-ep may be the best indicator in differentiation between malignant and benign breast lesions. Level of Evidence: 4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2018;47:91-96.