Contribution of IVIM to Conventional Dynamic Contrast-Enhanced and Diffusion-Weighted MRI in Differentiating Benign from Malignant Breast Masses

Abstract

Background: The aim of this study was to determine whether the indicators obtained from intravoxel incoherent motion (IVIM) imaging can improve the characterization of benign and malignant breast masses compared with conventional dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted magnetic resonance imaging (DW-MRI). Patients and Methods: This study included 23 benign and 31 malignant breast masses of 48 patients. Main indicators were initial enhancement ratio (IER), time-signal intensity curve (TIC), apparent diffusion coefficient (ADC), tissue diffusivity (D), pseudodiffusivity (D*), and perfusion fraction (f). The discriminative abilities of the different models were compared by means of receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) analysis. Results: D had the highest AUC (0.980), sensitivity (93.55%), specificity (100%), and diagnostic accuracy (96.36%). Both D and TIC could provide the independent predicted features for malignant breast masses. The combination of D and TIC had an AUC of up to 0.990. Conclusion: D of IVIM can effectively complement existing conventional DCE-MRI and DW-MRI in differentiating malignant from benign breast masses. IVIM combined with DCE-MRI is a robust means of evaluating breast masses.

Utility of intravoxel incoherent motion MRI derived parameters for prediction of aggressiveness in urothelial bladder carcinoma

“…Especially, the combination of D and f values showed higher AUC, specificity and accuracy than single ADC value (AUC, 0.931 versus 0.895; specificity, 100% versus 90.48%; accuracy, 91.82% versus 85.97%) for distinguishing high‐aggressiveness from low‐/intermediate‐aggressive bladder cancer, but the sensitivity of combination of D and f values was slightly lower than that of ADC value ( 73.91% versus 76.09%). The study of Wang et al also draws a conclusion that the combination of D and ADC values showed better diagnostic performance than single ADC value for differentiating malignant from benign breast masses, which was partially similar to our study.…”

Intravoxel incoherent motion (IVIM) histogram biomarkers for prediction of neoadjuvant treatment response in breast cancer patients

“…While IVIM metrics can distinguish between benign and malignant breast lesions [2] , [3] , [5] , [11] , [13] , there is also interest in determining whether these IVIM metrics can predict treatment response or segment patient populations based on degree of response to treatment. Neoadjuvant treatment (NAT), which has traditionally been used for locally advanced breast cancer [14] , is increasingly used in operable breast cancer because it can be as effective as adjuvant chemotherapy.…”

Breast lesion characterization using whole‐lesion histogram analysis with stretched‐exponential diffusion model

“…1 Conventional MRI can offer high sensitivity (90%) for the detection of malignant tumors; however, its specificity is relatively low (72%). Biexponential intravoxel incoherent motion (IVIM), [5][6][7][8] stretched-exponential, 9,10 and kurtosis models 11,12 have been proposed to better model the complexities of water motion in tissue. DWI quantitatively measures the extent to which the diffusion of water is restricted, and has been shown to be a promising imaging marker for differentiating benign from malignant tumors.…”

“…This is because water motion in breast tissue is composed not only of Brownian motion, but also shows noticeable contributions from microperfusion and other phenomena. Biexponential intravoxel incoherent motion (IVIM), [5][6][7][8] stretched-exponential, 9,10 and kurtosis models 11,12 have been proposed to better model the complexities of water motion in tissue. While the IVIM model provides both perfusion and diffusion information, the optimal distribution of b-values remains an open question, 13 and the reliance on four parameters in the model leads to difficulties in calculating and interpreting results.…”