A Meta-analysis of the Diagnostic Performance of Diffusion MRI for Breast Lesion Characterization
A Meta-analysis of the Diagnostic Performance of Diffusion MRI for Breast Lesion Characterization
复制标题
DOI：
10.1148/radiol.2019182510
复制
发表时间：
2019-06-01
期刊：
影响因子：
19.7
通讯作者：
Patterson, Andrew J.
中科院分区：
文献类型：
--
作者：
Baxter, Gabrielle C.;Graves, Martin J.;Patterson, Andrew J.
背景：有多种技术可用于评估乳腺病变的扩散特性，作为MRI恶性肿瘤的标志。这些扩散标记物的诊断性能尚未得到全面评估。目的：通过荟萃分析比较扩散加权成像（DWI）、扩散张量成像（DTI）和体素内非相干运动（IVIM）参数在乳腺良恶性病变鉴别诊断中的诊断性能。材料和方法：检索了2018年1月至3月的PubMed和Embase数据库，以查找评估DWI、DTI和IVIM在乳腺中诊断性能的英文研究。根据合格性和排除标准对研究进行审查。评估研究间的发表偏倚和异质性。通过使用双变量模型获得每个参数的灵敏度、特异性和曲线下面积的汇总汇总估计值。亚分析研究MRI参数对诊断性能的影响，通过使用学生t检验或单向方差分析。结果：从73个合格的研究，6791病变（3930恶性和2861良性）。对于评价表观扩散系数（ADC）的研究，发表偏倚明显。除灌注分数（f）外，所有参数均存在显著异质性（P <0.05）。ADC的合并灵敏度、特异性和曲线下面积分别为89%、82%和0.92。DTI的最高性能参数是主扩散系数（λ（1）），合并的灵敏度，特异性和曲线下面积分别为93%，90%和0.94。IVIM的最高性能参数是组织扩散率（D），合并的灵敏度、特异性和曲线下面积分别为88%、79%和0.90。MRI参数的选择没有显着的影响上的诊断performance.Conclusion：扩散加权成像，扩散张量成像，和intravoxel非相干运动具有较高的敏感性和特异性的诊断准确性。体素内非相干运动与表观扩散系数相当。扩散张量成像是有潜力的，但迄今为止的研究数量有限。(C)RSNA，2019年
Background: Various techniques are available to assess diffusion properties of breast lesions as a marker of malignancy at MRI. The diagnostic performance of these diffusion markers has not been comprehensively assessed.Purpose: To compare by meta-analysis the diagnostic performance of parameters from diffusion-weighted imaging (DWI), diffusion-tensor imaging (DTI), and intravoxel incoherent motion (IVIM) in the differential diagnosis of malignant and benign breast lesions.Materials and Methods: PubMed and Embase databases were searched from January to March 2018 for studies in English that assessed the diagnostic performance of DWI, DTI, and IVIM in the breast. Studies were reviewed according to eligibility and exclusion criteria. Publication bias and heterogeneity between studies were assessed. Pooled summary estimates for sensitivity, specificity, and area under the curve were obtained for each parameter by using a bivariate model. A subanalysis investigated the effect of MRI parameters on diagnostic performance by using a Student t test or a one-way analysis of variance.Results: From 73 eligible studies, 6791 lesions (3930 malignant and 2861 benign) were included. Publication bias was evident for studies that evaluated apparent diffusion coefficient (ADC). Significant heterogeneity (P < .05) was present for all parameters except the perfusion fraction (f). The pooled sensitivity, specificity, and area under the curve for ADC was 89%, 82%, and 0.92, respectively. The highest performing parameter for DTI was the prime diffusion coefficient (lambda(1)), and pooled sensitivity, specificity, and area under the curve was 93%, 90%, and 0.94, respectively. The highest performing parameter for IVIM was tissue diffusivity (D), and the pooled sensitivity, specificity, and area under the curve was 88%, 79%, and 0.90. Choice of MRI parameters had no significant effect on diagnostic performance.Conclusion: Diffusion-weighted imaging, diffusion-tensor imaging, and intravoxel incoherent motion have comparable diagnostic accuracy with high sensitivity and specificity. Intravoxel incoherent motion is comparable to apparent diffusion coefficient. Diffusion-tensor imaging is potentially promising but to date the number of studies is limited. (C) RSNA, 2019