Characterization of breast tumors using diffusion kurtosis imaging (DKI)

Dongmei Wu; Guanwu Li; Junxiang Zhang; Shixing Chang; Jiani Hu; Yongming Dai

doi:10.1371/journal.pone.0113240

Characterization of breast tumors using diffusion kurtosis imaging (DKI)

PLoS One. 2014 Nov 18;9(11):e113240. doi: 10.1371/journal.pone.0113240. eCollection 2014.

Authors

Dongmei Wu¹, Guanwu Li², Junxiang Zhang³, Shixing Chang², Jiani Hu⁴, Yongming Dai⁵

Affiliations

¹ Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China; Department of Radiology, Wayne State University, Detroit, Michigan, United States of America.
² Department of Radiology, Yue Yang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
³ Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China.
⁴ Department of Radiology, Wayne State University, Detroit, Michigan, United States of America.
⁵ Philips Healthcare, Shanghai, China.

Abstract

Aim: The aim of this study was to investigate and evaluate the role of magnetic resonance (MR) diffusion kurtosis imaging (DKI) in characterizing breast lesions.

Materials and methods: One hundred and twenty-four lesions in 103 patients (mean age: 57 ± 14 years) were evaluated by MR DKI performed with 7 b-values of 0, 250, 500, 750, 1,000, 1,500, 2,000 s/mm2 and dynamic contrast-enhanced (DCE) MR imaging. Breast lesions were histologically characterized and DKI related parameters--mean diffusivity (MD) and mean kurtosis (MK)--were measured. The MD and MK in normal fibroglandular breast tissue, benign and malignant lesions were compared by One-way analysis of variance (ANOVA) with Tukey's multiple comparison test. Receiver operating characteristic (ROC) analysis was performed to assess the sensitivity and specificity of MD and MK in the diagnosis of breast lesions.

Results: The benign lesions (n = 42) and malignant lesions (n = 82) had mean diameters of 11.4 ± 3.4 mm and 35.8 ± 20.1 mm, respectively. The MK for malignant lesions (0.88 ± 0.17) was significantly higher than that for benign lesions (0.47 ± 0.14) (P < 0.001), and, in contrast, MD for benign lesions (1.97 ± 0.35 (10(-3) mm2/s)) was higher than that for malignant lesions (1.20 ± 0.31 (10(-3) mm2/s)) (P < 0.001). At a cutoff MD/MK 1.58 (10(-3) mm2/s)/0.69, sensitivity and specificity of MD/MK for the diagnosis of malignant were 79.3%/84.2% and 92.9%/92.9%, respectively. The area under the curve (AUC) is 0.86/0.92 for MD/MK.

Conclusions: DKI could provide valuable information on the diffusion properties related to tumor microenvironment and increase diagnostic confidence of breast tumors.

MeSH terms

Aged
Analysis of Variance
Breast Neoplasms / diagnosis*
Breast Neoplasms / pathology*
Diffusion Magnetic Resonance Imaging / methods*
Female
Humans
Image Processing, Computer-Assisted
Middle Aged
ROC Curve
Tumor Microenvironment*

Grants and funding

The authors received no specific funding for this work. As for co-author Yongming Dai employed by Philips Healthcare, the authors confirm that there is no competing interest and financial disclosure affiliated to Philips Healthcare, along with its employment, consultancy, patents, products in development or marketed products, etc. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.