Differentiation between phyllodes tumours and fibroadenomas using intravoxel incoherent motion magnetic resonance imaging: comparison with conventional diffusion-weighted imaging

Br J Radiol. 2018 Apr;91(1084):20170687. doi: 10.1259/bjr.20170687. Epub 2018 Jan 31.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biopsy, Large-Core Needle
  • Breast Neoplasms / diagnostic imaging*
  • Contrast Media
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Fibroadenoma / diagnostic imaging*
  • Fibroadenoma / surgery
  • Gadolinium DTPA
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Phyllodes Tumor / diagnostic imaging*
  • Phyllodes Tumor / surgery
  • Retrospective Studies

Substances

  • Contrast Media
  • Gadolinium DTPA