Comparison of quantitative and semi-quantitative hemodynamic parameters of dynamic contrast-enhanced MRI for differentiating benign and malignant breast lesions / 中国医学影像技术

ABSTRACT

Objective To compare the diagnostic performance of quantitative and semi-quantitative hemodynamic parameters of breast dynamic contrast-enhanced MRI (DCE-MRI) in differential diagnosis of benign and malignant breast lesions. Methods Fifty-nine patients (66 lesions) with breast lesions underwent hybrid DCE MRI with high temporal and spatial resolution, and semi-quantitative and quantitative hemodynamic parameters were obtained. The semi-quantitative parameters included time-intensity curve (TIC), initial area under the gadolinium curve (IAUGC), maximum slope of increase (MaxSlope), contrast enhancement rate (CER) and positive enhancement integral (PEI), while quantitative parameters included volume transfer constant (Ktrans), rate constant (Kep) and extravascular extracellular volume fraction (Ve). The differences of all the parameters between benign and malignant breast lesions were compared by using non-parametric tests. ROC was used to analyze the diagnostic performance. Results There were 31 malignant lesions (malignant group) and 35 benign ones (benign group). There were significant differences of Ktrans, Kep, TIC, IAUGC and MaxSlope between the two groups (all P0.05). AUC of ROC curve of Ktrans, Kep, TIC, IAUGC and MaxSlope were all >0.7. AUC of semi-quantitative parameter combination in diagnosis of benign and malignant breast lesions were significantly higher than those of single parameter (all P<0.05), AUC of quantitative parameter in combination was not significantly higher than those of Ktrans (P=0.134), but significantly higher than those of Kep and Ve (all P<0 001). There was no significant difference in AUC between combined semi-quantitative and quantitative parameters in diagnosis of benign and malignant breast lesions (P=0.614). Conclusion Ktrans, Kep, TIC, IAUGC and MaxSlope have good diagnostic performance in differentiating benign and malignant breast lesions. The combined semi-quantitative and quantitative hemodynamic DCE-MRI parameters have similar diagnostic performance.