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. 2019 Aug;92(1100):20180978.
doi: 10.1259/bjr.20180978. Epub 2019 Jul 10.

Quantitative evaluation of computed and voxelwise computed diffusion-weighted imaging in breast cancer

Qingyuan Cheng  1 , Shuxin Ye  1 , Chuqi Fu  1 , Jiejie Zhou  1 , Xiaxia He  1 , Haiwei Miao  1 , Nina Xu  1 , Meihao Wang  1
Affiliations

Quantitative evaluation of computed and voxelwise computed diffusion-weighted imaging in breast cancer

Qingyuan Cheng et al. Br J Radiol. 2019 Aug.

Abstract

Objectives: To assess the value of computed diffusion-weighted imaging (cDWI) and voxelwise computed diffusion-weighted imaging (vcDWI) in breast cancer.

Methods: This retrospective study involved 130 patients (age range, 25-70 years; mean age ± standard deviation, 48.6 ± 10.5 years) with 130 malignant lesions, who underwent MRI examinations, including a DWI sequence, prior to needle biopsy or surgery. cDWIs with higher b-values of 1500, 2000, 2500, 3000, 3500, and 4000 s/mm2, and vcDWI were generated from measured (m) DWI with two lower b-values of 0/600, 0/800, or 0/1000 s/mm2. The signal-to-noise ratio (SNR) and contrast ratio (CR) of all image sets were computed and compared among different DWIs by two experienced radiologists independently. To better compare the CR with the SNR, the CR value was multiplied by 100 (CR100).

Results: The CR of vcDWI, and cDWIs, except for cDWI1000, differed significantly from that of measured diffusion-weighted imaging (mDWI) (cDWI1000: CR = 0.4904, p = 0.394; cDWI1500: CR = 0.5503, p = 0.006; cDWI2000: CR = 0.5889, p < 0.001; cDWI2500: CR = 0.6109, p < 0.001; cDWI3000: mean = 0.6214, p < 0.001; cDWI3500: CR = 0.6245, p < 0.001; cDWI4000: CR = 0.6228, p < 0.001). The vcDWI provided the highest CR, while the CRs of all cDWI image sets improved with increased b-values. The SNR of neither cDWI1000 nor vcDWI differed significantly from that of mDWI, but the mean SNRs of the remaining cDWIs were significantly lower than that of mDWI. The SNRs of cDWIs declined with increasing b-values, and the initial decrease at low b-values was steeper than the gradual attenuation at higher b-values; the CR100 rose gradually, and the two converged on the b-value interval of 1500-2000 s/mm2 .

Conclusions: The highest CR was achieved with vcDWI; this could be a promising approach easier detection of breast cancer.

Advances in knowledge: This study comprehensively compared and evaluated the value of the emerging post-processing DWI techniques (including a set of cDWIs and vcDWI) in breast cancer.

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Figures

Figure 1.
Figure 1.
Mean value of the CR for breast cancer. vcDWI provided the best CR, while the value of CR increased with increasing b-values in cDWIs. (*p < 0.05, as compared to mDWI). cDWI, computed diffusion-weighted imaging; CR, contrast ratio; mDWI, measured diffusion-weighted imaging.
Figure 2.
Figure 2.
Mean SNR for each DWI. SNRmean of cDWI1000 and vcDWI did not differ significantly from that of mDWI. In cDWIs, SNR decreased with increasing b-values, and the initial decrease at low b-values was steeper than the more gradual attenuation at higher b-values. (*p < 0.05 when compared to mDWI). cDWI, computed diffusion-weighted imaging; mDWI, measured diffusion-weighted imaging;SNR, signal-to-noise ratio; vcDWI, voxelwise computed diffusion-weighted imaging.
Figure 3.
Figure 3.
A plot of CR100 (the value of CR amplified 100 times) and SNR. With increasing b-values, SNR declined, while CR rose gradually. These two ratios converged at a b-value ranging from 1500 to 2000 s/mm2. Computed b-values in the range of 1500–2000 s/mm2 were optimal for breast cancer detection. cDWI, computed diffusion-weighted imaging; CR, contrast ratio;SNR, signal-to-noise ratio.
Figure 4.
Figure 4.
A 56-year-old female with a breast medullary carcinoma in the left lateral mammary. cDWI (a–g), vcDWI (h), mDWI (i). The lesion indicated extreme hyperintensity on vcDWI and cDWI with relatively lower b-values. With increasing b-values, image quality declined, and the lesion was not visible at cDWI4000. cDWI, computed diffusion-weighted imaging; mDWI, measured diffusion-weighted imaging; vcDWI, voxelwise computed diffusion-weighted imaging.
Figure 5.
Figure 5.
A 66-year-old female with an invasive ductal carcinoma in the deep center of the right mammary. cDWI (a–g), vcDWI (h), mDWI (i). The tumor was markedly more conspicuous on vcDWI and mDWI with a b-value 1000 mm/s2, with a more distinct margin, than on other DWIs. The lesion gradually became unclear with increasing b-values in cDWI. cDWI, computed diffusion-weighted imaging; mDWI, measured diffusion-weighted imaging; vcDWI, voxelwise computed diffusion-weighted imaging.
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