The values of diffusion kurtosis imaging and dynamic contrast enhancement imaging in the diagnosis of triple negative breast cancer

YIN Siyuan; GAO Ti; LIU Huijun; HU Xibin; WANG Weiwei

Abstract：Objective To explore the value of diffusion kurtosis imaging(DKI)combined with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the differential diagnosis of triple negative and non-triple negative breast cancer.Methods A total of 164 breast cancer patients confirmed by pathology were collected,including 46 cases in the triple negative group and 118 cases in the non-triple negative group.DKI and DCE-MRI were performed in all patients.The clinicopathological characteristics and conventional MRI features and mean diffusion rate(MD),mean kurtosis value(MK),volume transfer con-stant(Ktrans),extravascular extracellular space distribute volume per unit tissue volume(Ve)and rate constant(Kep)were ana-lyzed.And the ROC was plotted to compare the diagnostic efficiency.Results Irregular lesions in the triple negative group were less common than those in the non-triple negative group.The triple negative group had higher proportion of patients with heteroge-neous enhancement and rim enhancement(P=0.043).The MK and Ve values of the triple negative group were lower than those of the non-triple negative group(P<0.05),showing a low degree of negative correlation(r=-0.212,P=0.006;r=-0.480,P<0.001).The MD,Ktrans and Kep values of the triple negative group were higher than those of the non-triple negative group(P<0.05),showing a low degree of positive correlation(r=0.209～0.294,P<0.05).The AUC of Ve value was 0.808,which was higher than the other quantitative parameters(Z=2.192～2.895,P=0.028～0.038).The AUC of the DCE-MRI model was 0.851,which was higher than that of the DKI model(AUC=0.684)and conventional MRI model(AUC=0.645),and the difference was statisti-cally significant(Z=3.068,P=0.022;Z=3.546,P<0.001).The AUC of the combining DKI and DCE-MRI models was 0.885,the diagnostic performance was higher than the single model(Z=1.890～4.888,P<0.05).Conclusions DKI and DCE-MRI models can be used to diagnose the triple negative breast cancer.Among these,the Ve value of DCE-MRI model has the highest diagnostic efficiency.The diagnostic efficiency of DKI combined with DCE-MRI model to differentiate triple negative and non-triple negative breast cancer is better than that of a single model.