Diagnostic value of diffusion-weighted imaging with synthetic b-values in breast tumors: Comparison with dynamic contrast-enhanced and multiparametric MRI Journal Article
| Authors: | Daimiel Naranjo, I.; Lo Gullo, R.; Saccarelli, C.; Thakur, S. B.; Bitencourt, A.; Morris, E. A.; Jochelson, M. S.; Sevilimedu, V.; Martinez, D. F.; Pinker-Domenig, K. |
| Article Title: | Diagnostic value of diffusion-weighted imaging with synthetic b-values in breast tumors: Comparison with dynamic contrast-enhanced and multiparametric MRI |
| Abstract: | Objectives: To assess DWI for tumor visibility and breast cancer detection by the addition of different synthetic b-values. Methods: Eighty-four consecutive women who underwent a breast-multiparametric-MRI (mpMRI) with enhancing lesions on DCE-MRI (BI-RADS 2–5) were included in this IRB-approved retrospective study from September 2018 to March 2019. Three readers evaluated DW acquired b-800 and synthetic b-1000, b-1200, b-1500, and b-1800 s/mm2 images for lesion visibility and preferred b-value based on lesion conspicuity. Image quality (1–3 scores) and breast composition (BI-RADS) were also recorded. Diagnostic parameters for DWI were determined using a 1–5 malignancy score based on qualitative imaging parameters (acquired + preferred synthetic b-values) and ADC values. BI-RADS classification was used for DCE-MRI and quantitative ADC values + BI-RADS were used for mpMRI. Results: Sixty-four malignant (average = 23 mm) and 39 benign (average = 8 mm) lesions were found in 80 women. Although b-800 achieved the best image quality score, synthetic b-values 1200–1500 s/mm2 were preferred for lesion conspicuity, especially in dense breast. b-800 and synthetic b-1000/b-1200 s/mm2 values allowed the visualization of 84–90% of cancers visible with DCE-MRI performing better than b-1500/b-1800 s/mm2. DWI was more specific (86.3% vs 65.7%, p < 0.001) but less sensitive (62.8% vs 90%, p < 0.001) and accurate (71% vs 80.7%, p = 0.003) than DCE-MRI for breast cancer detection, where mpMRI was the most accurate modality accounting for less false positive cases. Conclusion: The addition of synthetic b-values enhances tumor conspicuity and could potentially improve tumor visualization particularly in dense breast. However, its supportive role for DWI breast cancer detection is still not definite. Key Points: • The addition of synthetic b-values (1200–1500 s/mm2) to acquired DWI afforded a better lesion conspicuity without increasing acquisition time and was particularly useful in dense breasts. • Despite the use of synthetic b-values, DWI was less sensitive and accurate than DCE-MRI for breast cancer detection. • A multiparametric MRI modality still remains the best approach having the highest accuracy for breast cancer detection and thus reducing the number of unnecessary biopsies. © 2020, The Author(s). |
| Keywords: | image analysis; diagnostic imaging; diffusion magnetic resonance imaging; echo-planar imaging; breast tumors |
| Journal Title: | European Radiology |
| Volume: | 31 |
| Issue: | 1 |
| ISSN: | 0938-7994 |
| Publisher: | Springer |
| Date Published: | 2021-01-01 |
| Start Page: | 356 |
| End Page: | 367 |
| Language: | English |
| DOI: | 10.1007/s00330-020-07094-z |
| PUBMED: | 32780207 |
| PROVIDER: | scopus |
| PMCID: | PMC7755636 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 January 2021 -- Source: Scopus |
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MSK Authors
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334Morris -
119Jochelson -
92Thakur -
40Martinez -
189Pinker-Domenig -
17Bitencourt -
26Lo Gullo
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