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Clinical Article
Value of syMRI and DWI quantitative parameters measured using different regions of interest method in differentiating benign and malignant breast lesions
SONG Meina  DONG Lei  HE Hua  SUN Jie  SONG Jiang  GAO Na  WANG Zhijun 

Cite this article as: Song MN, Dong L, He H, et al. Value of syMRI and DWI quantitative parameters measured using different regions of interest method in differentiating benign and malignant breast lesions[J]. Chin J Magn Reson Imaging, 2022, 13(6): 17-22, 27. DOI:10.12015/issn.1674-8034.2022.06.004.


[Abstract] Objective To investigate the value of synthetic magnetic resonance imaging (syMRI) and diffusion weighted imaging (DWI) quantitative parameters measured using different regions of interest (ROI) method in differentiating benign and malignant breast mass-like lesions.Materials and Methods All patients underwent MRI scanning, including T2WI, dynamic contrast-enhanced MRI, DWI and syMRI. Two readers used the method of holistic drawing of lesions to outline ROI respectively, the ROI was drawn along the edge and recorded as "tumor". At the maximum slice of the lesion, the ROI was drawn along the edge and recorded as "max". In the solid area with the most obvious tumor enhancement, the ROI was drawn and recorded as "local". At the same time, apparent diffusion coefficient (ADC) values (ADCtumor, ADCmax and ADClocal) were measured in the ADC map according to the tumor enhancement position in the dynamic enhanced image. T1 relaxation time (T1tumor, T1max and T1local) were measured on T1 mapping images. T2 relaxation time (T2tumor, T2max and T2local) were measured on T2 mapping images. Proton density (PDtumor, PDmax and PDlocal) were measured on PD mapping images. The reader 1 repeated the above measurement after an interval of one month. The inter-class correlation coefficient (ICC) was calculated to evaluate the repeatability of the results measured by different physicians using different ROI delineation methods. Comparison of the differences of various parameters between benign and malignant breast lesions. The receiver operating characteristic (ROC) area under the curve (AUC) was used to evaluate the differential diagnosis performance of syMRI, DWI and their combination in benign and malignant lesions. Delong test was used to compare AUC.Results Using different ROI delineation methods, the ADC value, T1 value, T2 value and PD value measured by the same physician twice and between different physicians were reproducible (ICC range 0.929-0.992). The ADC value, T2 value and PD value obtained by the three ROI delineation methods were all significantly different between benign and malignant breast lesions (all P<0.001). Multivariate logistic regression analysis showed that ADClocal, T2tumor and PDlocal were independent variables in the diagnosis of breast cancer. The OR values were 0.001, 0.917 and 1.267, respectively (P=0.013, 0.039 and 0.043). ROC curve analysis showed that ADClocal+T2tumor+PDlocal had the highest AUC for differential diagnosis of benign and malignant breast lesions (0.953), with a sensitivity of 95.2%, a specificity of 84.2%, an accuracy of 91.0%, a positive predictive value of 93.0%, and a negative predictive value of 88.8%. There was no significant difference in diagnostic efficiency between ADClocal+T2tumor+PDlocal and ADClocal (AUC=0.953, 0.942; P=0.143).Conclusions For breast mass lesions, syMRI and DWI parameters are helpful to differentiating malignancy from benign lesions, the diagnostic performance of combined parameters model was comparable to that of the ADC value.
[Keywords] breast neoplasms;magnetic resonance imaging;synthetic magnetic resonance imaging;diffusion weighted imaging;region of interest

SONG Meina1   DONG Lei2   HE Hua2   SUN Jie1   SONG Jiang1   GAO Na1   WANG Zhijun2*  

1 Graduate School, Ningxia Medical University, Yinchuan 750004, China

2 Department of Radiology,General Hospital of Ningxia Medical University, Yinchuan 750004, China

WANG ZJ, E-mail: wangzhijun2056@163.com

Conflicts of interest   None.

Received  2022-01-20
Accepted  2022-05-31
DOI: 10.12015/issn.1674-8034.2022.06.004
Cite this article as: Song MN, Dong L, He H, et al. Value of syMRI and DWI quantitative parameters measured using different regions of interest method in differentiating benign and malignant breast lesions[J]. Chin J Magn Reson Imaging, 2022, 13(6): 17-22, 27.DOI:10.12015/issn.1674-8034.2022.06.004

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