Highlights
- •APTw imaging can be used prospectively differentiating benign from malignant tumors.
- •APTw imaging yielded similar diagnosis performance in discriminating benign and malignant breast tumors when compared to the DCE and better than DWI imaging.
- •The APTw value showed a negative correlation with ER expression.
Abstract
Objective
To explore the value of amide proton transfer-weighted (APTw) magnetic resonance imaging
(MRI) for differential diagnosis of fibroadenomas and malignant breast tumors.
Materials and methods
This prospective study enrolled 56 patients with suspected breast tumors and performed
APTw imaging. Based on the histopathology results, patients were divided into group
1 with malignant breast tumors (n = 41) and group 2 with fibroadenomas (n = 15). The measured image parameters (APTw value, ADC value, type of Time of Intensity
Curve, maximum tumor diameter in image) and the maximal diameter of the tumors measured
from surgical resection were compared between the two groups, and the diagnostic performance
based on these parameters was quantified with ROC curve. Spearman's correlation coefficient
was used to analyze the association between APTw or ADC values and ER, PR, HER2, and
Ki-67 expressions.
Results
The intraclass correlation coefficients (ICC = 0.87 and 0.91) indicated a good inter-observer
agreement of the measured APTw values. APTw values of malignant lesions were significantly
higher than those of fibroadenomas (3.21 ± 1.04% vs 1.50 ± 0.54%, p < 0.001). Area under the curve (AUC) obtained from APTw imaging, DWI, DCE, APTw imaging+DWI,
APTw imaging+DWI, and APTw imaging+DWI + DCE was 0.959, 0.897, 0.976, 0.997, and 1
respectively. The APTw value showed a negative correlation with ER expression (r = −0.357).
Conclusion
APTw imaging yielded similar diagnosis performance in discriminating fibroadenomas
and malignant breast tumors when compared to the DCE and better than DWI imaging,
and provided supplement information on tumor cell activity to DWI images. The APTw
value showed correlations with some prognostic factors for breast cancer.
Keywords
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Article info
Publication history
Published online: September 25, 2021
Accepted:
September 6,
2021
Received in revised form:
September 1,
2021
Received:
May 18,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
