Feasibility study of dual parametric 2D histogram analysis of breast lesions with dynamic contrast-enhanced and diffusion-weighted MRI

Abstract

BackgroundThis study aimed to investigate the diagnostic value of a dual-parametric 2D histogram classification method for breast lesions.MethodsThis study included 116 patients with 72 malignant and 44 benign breast lesions who underwent CAIPIRINHA-Dixon-TWIST-VIBE dynamic contrast-enhanced (CDT-VIBE DCE) and readout-segmented diffusion-weighted magnetic resonance examination. The volume of interest (VOI), which encompassed the entire lesion, was segmented from the last phase of DCE images. For each VOI, a 1D histogram analysis (mean, median, 10th percentile, 90th percentile, kurtosis and skewness) was performed on apparent diffusion coefficient (ADC) and volume transfer constant (Ktrans) maps; a 2D histogram image (Ktrans-ADC) was generated from the pixelwise aligned maps, and its kurtosis and skewness were calculated. Each parameter was correlated with pathological results using the Mann–Whitney test and receiver operating characteristic curve analysis.ResultsFor the Ktrans histogram, the area under the curve (AUC) of the mean, median, 90th percentile and kurtosis had statistically diagnostic values (mean: 0.760; median: 0.661; 90th percentile: 0.781; and kurtosis: 0.620). For the ADC histogram, the AUC of the mean, median, 10th percentile, skewness and kurtosis had statistically diagnostic values (mean: 0.661; median: 0.677; 10th percentile: 0.656; skewness: 0.664; and kurtosis: 0.620). For the 2D Ktrans-ADC histogram, the skewness and kurtosis had statistically higher diagnostic values (skewness: 0.831, kurtosis: 0.828) than those of the 1D histogram (all P < 0.05).ConclusionsThe dual-parametric 2D histogram analysis revealed better diagnostic accuracy for breast lesions than single parametric histogram analysis of either Ktrans or ADC maps.

Diagnostic performance of whole-lesion apparent diffusion coefficient histogram analysis metrics for differentiating benign and malignant breast lesions: a systematic review and diagnostic meta-analysis

“…Four studies used histopathology as the reference standard (30–33), whereas only one used histopathology and clinical follow-up (34). MRI reviewers blinded to other test results and clinical data were reported in three studies (30,31,34) and two studies were unclear (32,33). Five studies provided diagnostic findings for 10th percentile ADC value (30–34), three studies provided diagnostic findings for 90th percentile ADC value (30,33,34) and mean (30,33,34), two studies provided diagnostic findings for 50th percentile ADC value (30,34), skewness (33,34), and mode (30,34), and one study provided diagnostic findings for 5th percentile (30), 25th percentile (30), 75th percentile (30), 95th percentile (30), maximum (30), median (33), entropy (33), and kurtosis (34).…”

“…Regarding the flow and timing domain, one study had high risk of bias due to different methods of verification (pathology or clinical follow-up) within the study (34). Three studies were considered to have unclear risk of bias because the interval between MRI and reference standard was not provided (30,32,33). Three studies had high concern (30,31,34) and one had unclear concern (33) for applicability regarding the patient selection.…”

“…Three studies were considered to have unclear risk of bias because the interval between MRI and reference standard was not provided (30,32,33). Three studies had high concern (30,31,34) and one had unclear concern (33) for applicability regarding the patient selection. Two studies had unclear concern (32,33) for applicability regarding the index test.…”

“…Three studies had high concern (30,31,34) and one had unclear concern (33) for applicability regarding the patient selection. Two studies had unclear concern (32,33) for applicability regarding the index test. All studies had low concern for applicability regarding the reference standard.…”

Diagnostic performance of breast tumor tissue selection in diffusion weighted imaging: A systematic review and meta-analysis

“…The number of malignant and benign lesions ranged from 14-259 and 8-161, respectively, with a mean of 61 malignant and 36 benign lesions per study subset. Seven study subsets were categorized as BTTS1: whole breast tumor tissue selection [35,[38][39][40][41][42][43], 22 as BTTS2: subtracted whole breast tumor tissue selection [15][16][17]20,23,36,37,[44][45][46][47][48][49][50][51][52][53][54][55][56][57][58], 19 as BTTS3: circular breast tumor tissue selection [18,19,21,24,25,36,[59][60][61][62][63][64][65][66][67][68][69][70][71] and 17 as BTTS4: lowest diffusion breast tumor tissue selection…”