Application of intravoxel incoherent motion diffusion-weighted imaging in differential diagnosis and molecular subtype analysis of breast cancer

Yichuan Ma; Dandan Shan; Jun Wei; Aiqi Chen

Application of intravoxel incoherent motion diffusion-weighted imaging in differential diagnosis and molecular subtype analysis of breast cancer

Am J Transl Res. 2021 Apr 15;13(4):3034-3043. eCollection 2021.

Authors

Yichuan Ma¹, Dandan Shan¹, Jun Wei¹, Aiqi Chen¹

Affiliation

¹ Department of Radiology, The First Affiliated Hospital of Bengbu Medical College Bengbu, Anhui Province, China.

PMID: 34017471
PMCID: PMC8129298

Abstract

Objective: To explore the application of incoherent motion diffusion-weighted imaging (IVIM-DWI) in the differential diagnosis and molecular subtype analysis of breast cancer.

Methods: The clinical data of 225 patients with breast masses were selected, including breast cancers (n = 135) and benign breast tumors (n = 90). According to pathological results, breast cancers were divided into four subtypes: Luminal A (n = 24), Luminal B (n = 57), HER-2-overexpression (n = 27) and triple-negative breast cancers (n = 27). The patients were detected by IVIM-DWI, and then the average diffusion coefficient (ADC), perfusion fraction (f) value, true dispersion coefficient (D) value and false dispersion coefficient (D*) value were compared and analyzed. The above index were used to identify breast cancer and its molecular subtypes by using the receiver operating characteristic (ROC) curve.

Results: The ADC, D and D*-value in breast cancer group were significantly lower than those in benign tumor group, while the f-value in breast cancer group was higher than that in benign tumor group (P<0.001); The ADC, D, D*, f-value and the combination of four have high diagnostic value in breast cancer; The D-value in PR-positive group was higher than that in the PR-negative group, while it was lower in PR-positive group (P<0.05), and the ADC, D and D*-value in the ER-positive group were significantly lower than those in the ER-negative group (P<0.001); The f-value in HER-2 positive group was higher than that in human epidermal growth factor receptor-2 (HER-2) negative group (P<0.001); The ADC and D-value of Ki-67 high-expression was lower than those of Ki-67 low-expression, while the D-value of Ki-67 high-expression was higher than that of Ki-67 low expression group (P<0.05); The ADC, D, D*, f-value and the combination of four have high diagnostic value in triple negative breast cancer.

Conclusion: IVIM-DWI technology has a significant value in differential diagnosis of benign and malignant breast tumors, and the relevant parameters of IVIM-DWI technology have definite value in the differential diagnosis of breast cancer molecular typing.

Keywords: Incoherent motion diffusion-weighted imaging; breast cancer; differential diagnosis; molecular subtype; receiver operating characteristic curve.