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Abstract：
To compare diffusion-kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) parameters of single-shot echo-planar imaging (ss-EPI) and readout-segmented echo-planar imaging (rs-EPI) in the differentiation of luminal vs. non-luminal breast cancer using histogram analysis. One hundred and sixty women with 111 luminal and 49 non-luminal breast lesions were enrolled in this study. All patients underwent ss-EPI and rs-EPI sequences on a 3.0T scanner. Histogram metrics were derived from mean kurtosis (MK), mean diffusion (MD) and the apparent diffusion coefficient (ADC) maps of two DWI sequences respectively. Student\'s t test or Mann-Whitney U test was performed for differentiating luminal subtype from non-luminal subtype. The ROC curves were plotted for evaluating the diagnostic performances of significant histogram metrics in differentiating luminal from non-luminal BC. The histogram metrics MKmean, MK50th, MK75th of luminal BC were significantly higher than those of non-luminal BC for both two DWI sequences (all P<0.05). Histogram metrics from rs-EPI sequence had better diagnostic performance in differentiating luminal from non-Luminal breast cancer compared to those from ss-EPI sequence. MK75th derived from rs-EPI sequence was the most valuable single metric (AUC, 0.891; sensitivity, 78.4%; specificity, 87.8%) for differentiating luminal from non-luminal BC among all the histogram metrics. Histogram metrics of MK derived from rs-EPI yielded better diagnostic performance for distinguishing luminal from non-luminal BC than that from ss-EPI. MK75th was the most valuable metric among all the histogram metrics.
摘要：
比较单次回波平面成像（ss-EPI）和读出分段回波平面成像（rs-EPI）的扩散峰度成像（DKI）和扩散加权成像（DWI）参数在腔内与腔内的区别使用直方图分析的非管腔乳腺癌。这项研究招募了一百六十名患有111个管腔和49个非管腔乳腺病变的妇女。所有患者在3.0T扫描仪上接受了ss-EPI和rs-EPI序列。直方图指标来自平均峰度(MK)，两个DWI序列的平均扩散（MD）和表观扩散系数（ADC）图。进行学生t检验或Mann-WhitneyU检验以区分腔亚型与非腔亚型。绘制ROC曲线以评估显著直方图度量在区分腔与非腔BC中的诊断性能。直方图度量MKmean，MK50，两个DWI序列的管腔BCMK75值均明显高于非管腔BC（均P<0.05）。与来自ss-EPI序列的直方图度量相比,来自rs-EPI序列的直方图度量在区分管腔与非管腔乳腺癌方面具有更好的诊断性能。从rs-EPI序列得出的MK75是最有价值的单一指标(AUC，0.891;灵敏度,78.4%;特异性,87.8%)用于在所有直方图度量中区分管腔与非管腔BC。与ss-EPI相比，rs-EPI得出的MK直方图指标在区分腔与非腔BC方面具有更好的诊断性能。MK75是所有直方图度量中最有价值的度量。
