Application of the diffusion kurtosis model for the study of breast lesions
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To evaluate diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in the differentiation and characterisation of breast lesions.
Thirty-six women underwent breast magnetic resonance imaging (MRI) including a DWI sequence with multiple b-values (50–3,000 s/mm2). Mean values for apparent diffusion coefficient (ADC), mean diffusivity (MD) and mean kurtosis (MK) were calculated by lesion type and histological subtype. Differences and correlation between parameters were determined.
Forty-four lesions were found. There were significant differences between benign and malignant lesions for all parameters (ADC, p = 0.017; MD, p = 0.028; MK, p = 0.017). ADC and MD were higher for benign (1.96 ± 0.41 × 10−3 and 2.17 ± 0.42 × 10−3 mm2/s, respectively) than for malignant lesions (1.33 ± 0.18 × 10−3 and 1.52 ± 0.50 × 10−3 mm2/s). MK was higher for malignant (0.61 ± 0.27) than benign lesions (0.37 ± 0.18). We found differences between invasive ductal carcinoma (IDC) and fibroadenoma (FA) for all parameters (ADC, MD and MK): p = 0.016, 0.022 and 0.016, respectively. FA and fibrocystic change (FC) showed differences only in MK (p = 0.016).
Diffusion in breast lesions follows a non-Gaussian distribution. MK enables differentiation and characterisation of breast lesions, providing new insights into microstructural complexity. To confirm these results, further investigation in a broader sample should be performed.
• The diffusion kurtosis model provides new information regarding breast lesions
• MD and MK are valid parameters to characterise tissue microstructure
• MK enables improved lesion differentiation
• MK is able to differentiate lesions that display similar ADC values
KeywordsDiffusion weighted imaging Diffusion kurtosis imaging Magnetic resonance imaging Breast lesions Mean kurtosis
Apparent diffusion coefficient
Probability of displacement function
Diffusion kurtosis imaging
Invasive ductal carcinoma
Invasive lobular carcinoma
The scientific guarantor of this publication is Isabel Maria Amorim Pereira Ramos. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This work was sponsored by Foundation of Science and Technology (FCT)/School of Health Technology of Porto (ESTSP)/Polytechnic Institute of Porto (IPP) with grant number: SFRH/BD/50027/2009 and grant number: PEst-OE/SAU/UI0645/2011. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.
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