Quantitative transport mapping (QTM) for differentiating benign and malignant breast lesion: Comparison with traditional kinetics modeling and semi-quantitative enhancement curve characteristics

Magn Reson Imaging. 2022 Feb:86:86-93. doi: 10.1016/j.mri.2021.10.039. Epub 2021 Nov 6.

Abstract

Purpose: To test the feasibility of using quantitative transport mapping (QTM) method, which is based on the inversion of transport equation using spatial deconvolution without any arterial input function, for automatically postprocessing dynamic contrast enhanced MRI (DCE-MRI) to differentiate malignant and benign breast tumors.

Materials and methods: Breast DCE-MRI data with biopsy confirmed malignant (n = 13) and benign tumors (n = 13) was used to assess QTM velocity (|u|) and diffusion coefficient (D), volume transfer constant (Ktrans), volume fraction of extravascular extracellular space (Ve) from kinetics method, and traditional enhancement curve characteristics (ECC: amplitude A, wash-in rate α, wash-out rate β). A Mann-Whitney U test and receiver operating characteristic curve (ROC) analysis were performed to assess the diagnostic performance of these parameters for distinguishing between benign and malignant tumors.

Results: Between malignant and benign tumors, there was a significant difference in |u| and Ktrans, (p = 0.0066, 0.0274, respectively), but not in D, Ve, A, α and β (p = 0.1119, 0.2382, 0.4418,0.2592 and 0.9591, respectively). ROC area-under-the-curve was 0.82, 0.75 (95% confidence level 0.60-0.95, 0.51-0.90) for |u| and Ktrans, respectively.

Conclusion: QTM postprocesses DCE-MRI automatically through deconvolution in space and time to solve the inverse problem of the transport equation. Comparing with traditional kinetics method and ECC, QTM method showed better diagnostic accuracy in differentiating benign from malignant breast tumors in this study.

Keywords: Arterial input function (AIF); Breast tumor diagnosis; Dynamic contrast enhanced (DCE) MRI; Fluid flow velocity; Quantitative Transport Mapping (QTM).

MeSH terms

  • Breast / diagnostic imaging
  • Breast Neoplasms* / diagnostic imaging
  • Contrast Media*
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Kinetics
  • Magnetic Resonance Imaging / methods
  • ROC Curve
  • Retrospective Studies

Substances

  • Contrast Media