Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imaging
Abstract This study aims to comprehensively evaluate the clinical utility of five diffusion models, including conventional mono-exponential (Mono), intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), stretched exponential (SEM), and continuous-time random-walk (CTRW), for preopera...
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| Language: | English |
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Nature Portfolio
2025-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-81713-3 |
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| author | Litong He Feng Li Yanjin Qin Yuling Li Qilan Hu Zhiqiang Liu Yunfei Zhang Tao Ai |
| author_facet | Litong He Feng Li Yanjin Qin Yuling Li Qilan Hu Zhiqiang Liu Yunfei Zhang Tao Ai |
| author_sort | Litong He |
| collection | DOAJ |
| description | Abstract This study aims to comprehensively evaluate the clinical utility of five diffusion models, including conventional mono-exponential (Mono), intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), stretched exponential (SEM), and continuous-time random-walk (CTRW), for preoperatively predicting of breast lesion pathology, prognostic biomarkers, and molecular subtypes. We retrospectively analyzed 132 patients with pathologically verified breast lesions (41 benign and 91 malignant) who underwent a full protocol preoperative breast MRI protocol, including a diffusion-weighted imaging (DWI) sequence with nine b values (0 to 2000 s/mm2) on a 3.0T MR scanner. The diffusion parameters from each model—Mono (ADC), IVIM (D, D*, f), DKI (MD, MK), SEM (DDC, α) and CTRW (Dm, α, β)—were quantitatively calculated and compared between benign and malignant breast lesions, as well as across different prognostic biomarker statuses in breast cancer, using Mann–Whitney U-tests. For molecular subtypes comparisons, we employed the Kruskal-Wallis test followed by Bonferroni. All parameters, except IVIM-D*, significantly differentiated benign from malignant lesions. Notably, IVIM-D and DKI-MK values were significantly different between estrogen receptor (ER)-positive and ER-negative tumors. Progesterone receptor (PR)-positive cancers exhibited lower Mono-ADC, IVIM-D, DKI-MD, SEM-DDC, CTRW-Dm, and CTRW-α values, alongside higher DKI-MK value compared to PR-negative cancers (p < 0.05). Significant differences in IVIM-D, IVIM-D*, and DKI-MK values were observed between human epidermal growth factor receptor 2 (HER2)-negative and HER2-positive tumors. Furthermore, higher SEM-α and CTRW-β values, along with lower DKI-MD and SEM-DDC values, were noted in the high Ki-67 expression group compared to the low Ki-67 group (p < 0.05). All five diffusion models proved valuable for breast cancer diagnosis, with the CTRW model exhibiting the highest diagnostic performance, although the difference was not statistically significant. The diffusion parameters derived from these models can effectively assist in distinguishing prognostic factors and molecular subtypes of breast cancer. |
| format | Article |
| id | doaj-art-1708ab2d93eb4f3c9ec72575ed46bded |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-1708ab2d93eb4f3c9ec72575ed46bded2025-02-09T12:36:30ZengNature PortfolioScientific Reports2045-23222025-02-0115111310.1038/s41598-024-81713-3Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imagingLitong He0Feng Li1Yanjin Qin2Yuling Li3Qilan Hu4Zhiqiang Liu5Yunfei Zhang6Tao Ai7Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceDepartment of Radiology, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Practice, Joint Service of Chinese People’s Liberation ArmyDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyMR Collaboration, Central Research Institute, United Imaging HealthcareDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract This study aims to comprehensively evaluate the clinical utility of five diffusion models, including conventional mono-exponential (Mono), intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), stretched exponential (SEM), and continuous-time random-walk (CTRW), for preoperatively predicting of breast lesion pathology, prognostic biomarkers, and molecular subtypes. We retrospectively analyzed 132 patients with pathologically verified breast lesions (41 benign and 91 malignant) who underwent a full protocol preoperative breast MRI protocol, including a diffusion-weighted imaging (DWI) sequence with nine b values (0 to 2000 s/mm2) on a 3.0T MR scanner. The diffusion parameters from each model—Mono (ADC), IVIM (D, D*, f), DKI (MD, MK), SEM (DDC, α) and CTRW (Dm, α, β)—were quantitatively calculated and compared between benign and malignant breast lesions, as well as across different prognostic biomarker statuses in breast cancer, using Mann–Whitney U-tests. For molecular subtypes comparisons, we employed the Kruskal-Wallis test followed by Bonferroni. All parameters, except IVIM-D*, significantly differentiated benign from malignant lesions. Notably, IVIM-D and DKI-MK values were significantly different between estrogen receptor (ER)-positive and ER-negative tumors. Progesterone receptor (PR)-positive cancers exhibited lower Mono-ADC, IVIM-D, DKI-MD, SEM-DDC, CTRW-Dm, and CTRW-α values, alongside higher DKI-MK value compared to PR-negative cancers (p < 0.05). Significant differences in IVIM-D, IVIM-D*, and DKI-MK values were observed between human epidermal growth factor receptor 2 (HER2)-negative and HER2-positive tumors. Furthermore, higher SEM-α and CTRW-β values, along with lower DKI-MD and SEM-DDC values, were noted in the high Ki-67 expression group compared to the low Ki-67 group (p < 0.05). All five diffusion models proved valuable for breast cancer diagnosis, with the CTRW model exhibiting the highest diagnostic performance, although the difference was not statistically significant. The diffusion parameters derived from these models can effectively assist in distinguishing prognostic factors and molecular subtypes of breast cancer.https://doi.org/10.1038/s41598-024-81713-3 |
| spellingShingle | Litong He Feng Li Yanjin Qin Yuling Li Qilan Hu Zhiqiang Liu Yunfei Zhang Tao Ai Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imaging Scientific Reports |
| title | Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imaging |
| title_full | Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imaging |
| title_fullStr | Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imaging |
| title_full_unstemmed | Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imaging |
| title_short | Enhanced preoperative prediction of breast lesion pathology, prognostic biomarkers, and molecular subtypes using multiple models diffusion-weighted MR imaging |
| title_sort | enhanced preoperative prediction of breast lesion pathology prognostic biomarkers and molecular subtypes using multiple models diffusion weighted mr imaging |
| url | https://doi.org/10.1038/s41598-024-81713-3 |
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