Intravoxel incoherent motion (IVIM) in evaluation of breast lesions: Comparison with conventional DWI

Liu, Chunling; Liang, Changhong; Liu, Zaiyi; Zhang, Shuixing; Huang, Biao

doi:10.1016/j.ejrad.2013.08.006

Cited by 176 publications

(211 citation statements)

References 28 publications

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“…In our study, the mean f value of benign breast masses was lower than that of malignant ones, and f could further increase the diagnostic sensitivity compared with ADC, although the AUC value of f was the lowest in the present study. Compared with another breast IVIM study by Liu et al [7], in our study the mean D* value and f value for both benign and malignant breast lesions were relatively lower. This may be due to the different quantity and distribution of low and high b-values used in IVIM.…”

Section: Discussioncontrasting

confidence: 83%

“…Compared with ADC, D* cannot further increase the diagnostic sensitivity and speciﬁcity. This may be related to the varying tumor vascularity among different masses [7]. In our study, the mean f value of benign breast masses was lower than that of malignant ones, and f could further increase the diagnostic sensitivity compared with ADC, although the AUC value of f was the lowest in the present study.…”

Section: Discussioncontrasting

confidence: 52%

“…However, the overlaps of DCE-MRI and ADC in malignant and benign breast lesions indicate that neither is as such the best tool for diagnosing breast lesions [3,4,5,6]. Intravoxel incoherent motion (IVIM) imaging has been applied for the characterization of breast cancer and discrimination between breast cancer and benign breast lesions [7,8]; however, so far, it has not been shown whether IVIM alone or combined with DCE-MRI or DW-MRI could provide better diagnostic accuracy than DCE-MRI or DW-MRI alone.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…We only focused on malignant breast tumors in which more pronounced IVIM effect could be presumed. The discrimination of normal tissue, precursor and advanced breast tumors using IVIM parameters (15,42) is beyond the study purpose. We did not correlate the IVIM parameters to pathology or clinical outcome either because of the retrospective nature of this study.…”

Section: Resultsmentioning

confidence: 99%

Statistical assessment of bi-exponential diffusion weighted imaging signal characteristics induced by intravoxel incoherent motion in malignant breast tumors

Yuan¹,

Wong²,

Lo³

et al. 2016

Quant. Imaging Med. Surg.

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Background: The purpose of this study is to statistically assess whether bi-exponential intravoxel incoherent motion (IVIM) model better characterizes diffusion weighted imaging (DWI) signal of malignant breast tumor than mono-exponential Gaussian diffusion model.Methods: 3 T DWI data of 29 malignant breast tumors were retrospectively included. Linear least-square mono-exponential fitting and segmented least-square bi-exponential fitting were used for apparent diffusion coefficient (ADC) and IVIM parameter quantification, respectively. F-test and Akaike Information Criterion (AIC) were used to statistically assess the preference of mono-exponential and bi-exponential model using region-of-interests (ROI)-averaged and voxel-wise analysis.Results: For ROI-averaged analysis, 15 tumors were significantly better fitted by bi-exponential function and 14 tumors exhibited mono-exponential behavior. The calculated ADC, D (true diffusion coefficient) and f (pseudo-diffusion fraction) showed no significant differences between mono-exponential and biexponential preferable tumors. Voxel-wise analysis revealed that 27 tumors contained more voxels exhibiting mono-exponential DWI decay while only 2 tumors presented more bi-exponential decay voxels. ADC was consistently and significantly larger than D for both ROI-averaged and voxel-wise analysis.Conclusions: Although the presence of IVIM effect in malignant breast tumors could be suggested, statistical assessment shows that bi-exponential fitting does not necessarily better represent the DWI signal decay in breast cancer under clinically typical acquisition protocol and signal-to-noise ratio (SNR). Our study indicates the importance to statistically examine the breast cancer DWI signal characteristics in practice.

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“…The ADC values are affected by acquisition parameters like the strength and duration of diffusion gradients as well as by physiological parameters like micro-perfusion [17]. Therefore, DWI should be quantified using a bi-exponential model like the intra-voxel incoherent motion (IVIM) model, resulting in increased diagnostic performance as compared to ADC [20].…”

Section: Diagnostic Imaging In Patients With Non-calcified Mammographmentioning

confidence: 99%

Breast cancer: a new imaging approach as an addition to existing guidelines

Dorrius

Vries

Slart

et al. 2015

Eur J Nucl Med Mol Imaging

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Intravoxel incoherent motion (IVIM) in evaluation of breast lesions: Comparison with conventional DWI

Cited by 176 publications

References 28 publications

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

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

Statistical assessment of bi-exponential diffusion weighted imaging signal characteristics induced by intravoxel incoherent motion in malignant breast tumors

Breast cancer: a new imaging approach as an addition to existing guidelines

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