Influence of residual fat signal on diffusion kurtosis MRI of suspicious mammography findings

Recent studies showed the potential of diffusion kurtosis imaging (DKI) as a tool for improved classification of suspicious breast lesions. However, in diffusion-weighted imaging of the female breast, sufficient fat suppression is one of the main factors determining the success. In this study, the d...

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Main Authors: Młynarska-Bujny, Anna (Author) , Bickelhaupt, Sebastian (Author) , Laun, Frederik B. (Author) , König, Franziska (Author) , Lederer, Wolfgang (Author) , Daniel, Heidi (Author) , Ladd, Mark E. (Author) , Schlemmer, Heinz-Peter (Author) , Delorme, Stefan (Author) , Kuder, Tristan Anselm (Author)
Format: Article (Journal)
Language:English
Published: 06 August 2020
In: Scientific reports
Year: 2020, Volume: 10, Pages: 1-12
ISSN:2045-2322
DOI:10.1038/s41598-020-70154-3
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/s41598-020-70154-3
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/s41598-020-70154-3
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Author Notes:Anna Mlynarska-Bujny, Sebastian Bickelhaupt, Frederik Bernd Laun, Franziska König, Wolfgang Lederer, Heidi Daniel, Mark Edward Ladd, Heinz-Peter Schlemmer, Stefan Delorme & Tristan Anselm Kuder

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520 |a Recent studies showed the potential of diffusion kurtosis imaging (DKI) as a tool for improved classification of suspicious breast lesions. However, in diffusion-weighted imaging of the female breast, sufficient fat suppression is one of the main factors determining the success. In this study, the data of 198 patients examined in two study centres was analysed using standard diffusion and kurtosis evaluation methods and three DKI fitting approaches accounting phenomenologically for fat-related signal contamination of the lesions. Receiver operating characteristic curve analysis showed the highest area under the curve (AUC) for the method including fat correction terms (AUC = 0.85, p < 0.015) in comparison to the values obtained with the standard diffusion (AUC = 0.77) and kurtosis approach (AUC = 0.79). Comparing the two study centres, the AUC value improved from 0.77 to 0.86 (p = 0.036) using a fat correction term for the first centre, while no significant difference with no adverse effects was observed for the second centre (AUC 0.89 vs. 0.90, p = 0.95). Contamination of the signal in breast lesions with unsuppressed fat causing a reduction of diagnostic performance of diffusion kurtosis imaging may potentially be counteracted by proposed adapted evaluation methods. 
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