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Chen X.,Comprehensive Breast Health Center | Fei X.,Shanghai JiaoTong University | Fu C.,Siemens AG | Yan X.,Siemens AG | Shen K.,Comprehensive Breast Health Center
Radiology | Year: 2015

Purpose: To assess diagnostic accuracy with diffusion kurtosis imaging (DKI) in patients with breast lesions and to evaluate the potential association between DKI-derived parameters and breast cancer clinical-pathologic factors. Materials and Methods: Institutional review board approval and written informed consent were obtained. Data from 97 patients (mean age 6 standard deviation, 45.7 years 6 13.1; range, 19-70 years) with 98 lesions (57 malignant and 41 benign) who were treated between January 2014 and April 2014 were retrospectively analyzed. DKI (with b values of 0-2800 sec/mm2) and conventional diffusion-weighted imaging data were acquired. Kurtosis and diffusion coefficients from DKI and apparent diffusion coefficients from diffusion-weighted imaging were measured by two radiologists. Student t test, Wilcoxon signed-rank test, Jonckheere-Terpstra test, receiver operating characteristic curves, and Spearman correlation were used for statistical analysis. Results: Kurtosis coefficients were significantly higher in the malignant lesions than in the benign lesions (1.05 6 0.22 vs 0.65 6 0.11, respectively; P , .0001). Diffusivity and apparent diffusion coefficients in the malignant lesions were significantly lower than those in the benign lesions (1.13 6 0.27 vs 1.97 6 0.33 and 1.02 6 0.18 vs 1.48 6 0.33, respectively; P , .0001). Significantly higher specificity for differentiation of malignant from benign lesions was shown with the use of kurtosis and diffusivity coefficients than with the use of apparent diffusion coefficients (83% [34 of 41] and 83% [34 of 41] vs 76% [31 of 41], respectively; P , .0001) with equal sensitivity (95% [54 of 57]). In patients with invasive breast cancer, kurtosis was positively correlated with tumor histologic grade (r = 0.75) and expression of the Ki-67 protein (r = 0.55). Diffusivity was negatively correlated with tumor histologic grades (r = 20.44) and Ki-67 expression (r = 20.46). Conclusion: DKI showed higher specificity than did conventional diffusion-weighted imaging for assessment of benign and malignant breast lesions. Patients with grade 3 breast cancer or tumors with high expression of Ki-67 were associated with higher kurtosis and lower diffusivity coefficients; however, this association must be confirmed in prospective studies. © RSNA, 2015.

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