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Optimal b-values for diffusion kurtosis imaging in invasive ductal carcinoma versus ductal carcinoma in situ breast lesions

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Abstract

Diffusion kurtosis imaging (DKI) is a diffusion-weighted MRI technique that probes the non-Gaussian diffusion of water molecules within biological tissues. The purpose of this study was to investigate the DKI model optimal b-values combinations in invasive ductal carcinoma (IDC) versus ductal carcinoma in situ (DCIS) breast lesions. The study included 114 malignant breast lesions (64 IDC and 50 DCIS). Patients underwent a breast MRI examination which included a diffusion-weighted sequence (b = 0–3000 s/mm2). For each lesion, the b-values were combined among each other (109 combinations) and each mean kurtosis (MK) parameter was obtained. Differences between the lesion groups and b-values combinations were assessed. Also, the diagnostic performance of the combinations was determined through receiver operating characteristic (ROC) curve analysis, and compared. Root mean square error (RMSE) was also obtained. All the b-values combinations showed significant differences between the lesion groups (p < 0.05). The combination 0, 50, 200, 750, 1000, 2000 s/mm2 showed the best performance (AUC = 0.930, sensitivity = 95.3%, specificity = 82.0%, accuracy = 89.5%), with a RMSE of 17.65. The b-values combinations with the worst performance were composed of only high or ultra-high b-values, or with b = 1000 s/mm2 as the maximum b-value. Better results were obtained when zero b-value was included in the DKI model fitting with at least one b-value below 1000 s/mm2 and one b-value above 1000 s/mm2 (conserving b = 1000 s/mm2). Six was the optimal number of b-values, nonetheless other combinations with less b-values may be considered, but with a consequent diagnostic performance loss.

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Acknowledgements

This paper is supported by Fundação para a Ciência e a Tecnologia – FCT / MEC (PIDDAC) – under the Strategic Programme UID/BIO/00645/2013. The authors thank the participants of this study, and the Radiology Department staff of Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisboa, Portugal, involved in this study. The authors also thank Nuno Loução for assistance with the MRI sequence.

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  1. Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal

    Filipa Borlinhas, Raquel C. Conceição & Hugo A. Ferreira

  2. School of Health and Rehabilitation, Keele University, Staffordshire, ST5 5BG, UK

    Filipa Borlinhas

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  1. Filipa Borlinhas
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  2. Raquel C. Conceição
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Correspondence to Filipa Borlinhas.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Appendix

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Table 4 Complete ROC curve results for each of the 109 b-values combination in test
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Borlinhas, F., Conceição, R.C. & Ferreira, H.A. Optimal b-values for diffusion kurtosis imaging in invasive ductal carcinoma versus ductal carcinoma in situ breast lesions. Australas Phys Eng Sci Med 42, 871–885 (2019). https://doi.org/10.1007/s13246-019-00773-2

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