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Published on: December 15, 2014
Differentiation between phyllodes tumours and fibroadenomas using intravoxel incoherent motion magnetic resonance
Hiroko Kawashima1,2, Tosiaki Miyati1, Naoki Ohno1
11 Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University , Kanazawa , Japan.
Objective:
To investigate whether the parameters derived from intravoxel incoherent motion (IVIM) MRI could differentiate phyllodes tumours (PTs) from fibroadenomas (FAs) by comparing the apparent diffusion coefficient (ADC) values.
Methods:
This retrospective study included 7 FAs, 10 benign PTs (BPTs), 4 borderline PTs, and one malignant PT. Biexponential analyses of IVIM were performed using a 3 T MRI scanner. Quantitative IVIM parameters [pure diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and fraction (f)] were calculated. The ADC was also calculated using monoexponential fitting.
Results:
The D and ADC values showed an increasing tendency in the order of FA, BPT, and borderline or malignant PT (BMPT). No significant difference was found in the D value among the three groups. The ADC value of the BMPT group was significantly higher than that of the FA group (p = 0.048). The D* value showed an increasing tendency in the order of BMPT, BPT, and FA, and the D* value of the BMPT group was significantly lower than that of the FA group (p = 0.048).
Conclusion:
The D* derived from IVIM and the ADC were helpful for differentiating between FA and BMPT. Advances in knowledge: IVIM MRI examination showed that the perfusion-related diffusion coefficient is lower in borderline and malignant PTs than in FAs and the opposite is true for the ADC.
Insights
Intravoxel incoherent motion (IVIM) MRI parameters, specifically the perfusion-related diffusion coefficient (D*) and apparent diffusion coefficient (ADC), can help distinguish fibroadenomas (FAs) from borderline and malignant phyllodes tumors (BMPTs). Lower D* and higher ADC values are observed in BMPTs compared to FAs.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Distinguishing between fibroadenomas (FAs) and phyllodes tumors (PTs) is crucial in breast lesion management.
- Intravoxel incoherent motion (IVIM) MRI offers advanced quantitative imaging parameters beyond standard diffusion-weighted imaging.
Purpose of the Study:
- To evaluate the efficacy of IVIM MRI parameters, including the apparent diffusion coefficient (ADC), in differentiating FAs from PTs.
- To compare quantitative IVIM parameters such as pure diffusion coefficient (D) and perfusion-related diffusion coefficient (D*) between these breast lesions.
Main Methods:
- Retrospective analysis of 7 FAs, 10 benign PTs, 4 borderline PTs, and 1 malignant PT using a 3 T MRI scanner.
- Biexponential analysis of IVIM data to calculate D, D*, and f; monoexponential fitting was used for ADC calculation.
Main Results:
- The ADC values were significantly higher in borderline or malignant PTs (BMPTs) compared to FAs (p = 0.048).
- The D* values showed a trend of increasing from BMPT to FA, with significantly lower D* in BMPTs than FAs (p = 0.048).
- No significant difference in the D value was observed among the groups.
Conclusions:
- IVIM-derived D* and ADC values are valuable in differentiating FAs from BMPTs.
- IVIM MRI demonstrates that borderline and malignant PTs exhibit lower perfusion-related diffusion coefficients (D*) and higher ADC values compared to FAs.
