The Clinical Value Of IVIM Technique In Benign And Malignant Breast Lesions

1、Objective(1)To investigate the diagnostic value of parameters derived from diffusion-weighted imaging intravoxel incoherent motion (IVIM) model for benign and malignant breast lesions;(2) To investigate the characteristics of slow ADC、f-value、fast ADC and conventional ADC value of benign and malignant breast lesions,and compare these parameters with that of monoexponential Model analysis in their ability to discriminate benign lesions and malignant tumors.(3)To determine whether the parameters obtained from intravoxel incoherent motion(IVIM) can improve the characterization of mass-like benign and malignant breast lesions, compared with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).2、Materials and methodsRetrospective analysis during January 2015 to December 2015 to the first affiliated hospital of hunan university of TCM,and finally confirmed by biopsy or surgical pathology of 90 patients with mammary gland disease, a total of 93 lesions, benign 44 cases, a total of 45 lesions; 46 cases of malignant, a total of 48 lesions; all patients underwent mammary gland single b value and multi b value diffusion weighted imaging (DWI) and multiphase dynamic enhanced MRI (DCE-MRI)scans. Make use of GE AW4.6 workstation to deal with imagings,which can generate conventional ADC value、slow ADC、f-value and fast ADC value, and to generate time-signal intensity curve (TIC).The one-way ANOVA and independent-samples t test was used for comparison. To compare the TIC curve type between benign and malignant lesions with chi-square test.Draw the ROC curve to analysis and compare the ability of the parameters in differential diagnosis benign and malignant lesions.3、Results(1) The diagnostic value of IVIM model for benign and malignant breast lesions:there are significant differences among benign group, malignant group and control group in ADC value, slow ADC value, f value and fast ADC value. The slow ADC value of malignant lesions significantly lower than the benign lesions;the f value of malignant lesions significantly higher than the benign lesions;there are no significant differences between benign group and control group in fast ADC value.(2)The AUC of ADC value, slow ADC value for the differential diagnosis of benign and malignant lesions of breast are 0.87,0.97. The optimal threshold of ADC value and slow ADC value for the Differential diagnosis of benign and malignant lesions of breast were 1.22 ×10-3mm2/s、1.07×10-3mm2/s.The sensitivity of ADC value and slow ADC value were 82.2%、86.7%,and the specificity of ADC value and slow ADC value were 81.2%、95.8%.(3)Benign lesions showed most TIC of Type Ⅰ(55.56%),and malignant lesions showed most TIC of Type Ⅲ(54.17),both of benign and malignant lesions showed TIC of Type Ⅱ were also more (benign 37.78%, malignant 39.58%);If the Ⅱ, Ⅲ type curve as malignant lesions, diagnosis to type I curve is considered to be benign lesions, the AUC value (0.78) was lower than those of slow ADC value (0.97).4、ConclusionThe parameter (D value、slow ADC value、fast ADC value and f value)obtained from DWI intravoxel incoherent motion model would help to differential diagnosis of benign and malignant lesions of breast. Compare the parameters of monoexponential model DWI and biexponential model DWI,the diagnosis ability of slow ADC value which is the parameter of monoexponential model DWI is higher than conventional ADC value and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) time-signal intensity curve(TIC).