A comparative study of the value of amide proton transfer-weighted imaging and diffusion kurtosis imaging in the diagnosis and evaluation of breast cancer.

Abstract

OBJECTIVES:

To compare the value of amide proton transfer-weighted imaging (APTWI) and diffusion kurtosis imaging (DKI) in differentiating benign and malignant breast lesions and analyze the correlations between the derived parameters and prognostic factors of breast cancer.

METHODS:

One hundred thirty-five women underwent breast APTWI and DKI. The magnetization transfer ratio asymmetry (MTRasym (3.5 ppm)), apparent kurtosis coefficient (Kapp), and non-Gaussian diffusion coefficient (Dapp) were calculated according to the histological subtype, grade, and prognostic factors (Ki-67, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), lymph node metastasis, and maximum lesion diameter). The differences, efficacy, and correlation between the parameters were determined.

RESULTS:

The Kapp value was higher and the Dapp and MTRasym (3.5 ppm) values were lower in the malignant group than in the benign group (all p < 0.001; AUC (Kapp) = 0.913, AUC (Dapp) = 0.910, and AUC (MTRasym (3.5 ppm)) = 0.796). The differences in the AUC between Kapp and MTRasym (3.5 ppm) and between Dapp and MTRasym (3.5 ppm) were significant (p = 0.023, 0.046). Kapp was moderately correlated with the pathological grade (|r| = 0.724) and mildly correlated with Ki-67 and HER-2 expression (|r| = 0.454, 0.333). Dapp was moderately correlated with the pathological grade (|r| = 0.648) and mildly correlated with Ki-67 expression (|r| = 0.400). MTRasym (3.5 ppm) was only mildly correlated with the pathological grade (|r| = 0.468).

CONCLUSION:

DKI is superior to APTWI in differentiating between benign and malignant breast lesions. Each parameter is correlated with some prognostic factors to a certain extent.

KEY POINTS:

• DKI and APTWI provide valuable information regarding lesion characterization. • Kapp, Dapp, and MTRasym (3.5 ppm) are valid parameters for the characterization of tissue microstructure. • DKI is superior to APTWI in the study of breast cancer.

• Authors: Nan Meng, Xuejia Wang, Jing Sun, Dongming Han, Yan Bai, Wei Wei, Zhe Wang, Fei Jia, Kaiyu Wang, Meiyun Wang
• Journal: European radiology (Eur Radiol) Vol. 31 Issue 3 Pg. 1707-1717 (Mar 2021) ISSN: 1432-1084 [Electronic] Germany
• PMID: 32888071 (Publication Type: Journal Article)

Chemical References

• Amides
• Protons

Topics

• Amides
• Breast Neoplasms (diagnostic imaging)
• Diffusion Magnetic Resonance Imaging
• Diffusion Tensor Imaging
• Female
• Humans
• Protons
• Reproducibility of Results