scholarly journals Additive Value of Texture Analysis Based on Breast MRI for Distinguishing Between Benign and Malignant Non-mass Enhancement in Premenopausal Women

2020 ◽  
Author(s):  
Yu Tan ◽  
Hui Mai ◽  
Zhiqing Huang ◽  
Li Zhang ◽  
Chengwei Li ◽  
...  

Abstract Background: Non-mass enhancement (NME) is a diagnostic dilemma. Texture analysis (TA) could serve as an objective method to quantify tumor characteristics and growth patterns. However, there are few reports about TA use in NME diagnosis. To our knowledge, NME diagnosis based on the combination of the features noted on routine MRI and TA has not been reported.. The purpose of this study was to explore the value of TA in distinguishing between benign and malignant NME in premenopausal women. Methods: Women in whom NME was histologically proven (n = 147) were enrolled (benign: 58; malignant: 89) was retrospective. Then, 102 and 45 patients were classified as the training and validation groups, respectively. Scanning sequences included Fat-suppressed T2-weighted and fat-suppressed contrast-enhanced T1-weighted which were acquired on a 1.5T MRI system. Clinical and routine MR characteristics (CRMC) were evaluated by two radiologists according to the Breast Imaging and Reporting and Data system (2013). Texture features were extracted from all post-contrast sequences in the training group. The combination model was built and then assessed in the validation group. Pearson’s chi-square test and Mann-Whitney U test were used to compare categorical variables and continuous variables, respectively. Logistic regression analysis and receiver operating characteristic curve were employed to assess the diagnostic performance of CRMC, TA, and their combination model in NME diagnosis.Results: The combination model showed a superior diagnostic performance in differentiating between benign and malignant NME compared to that of CRMC or TA alone (AUC, 0.887 vs 0.832 vs 0.74). Moreover, compared to CRMC, the model showed high specificity (72.5% vs 80%). The results obtained in the validation group confirmed the model was promising.Conclusion: The combined use of TA and CRMC could afford an improved diagnostic performance in differentiating between benign and malignant NME.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu Tan ◽  
Hui Mai ◽  
Zhiqing Huang ◽  
Li Zhang ◽  
Chengwei Li ◽  
...  

Abstract Background Non-mass enhancement (NME) is a diagnostic dilemma and highly reliant on the experience of the radiologists. Texture analysis (TA) could serve as an objective method to quantify lesion characteristics. However, it remains unclear what role TA plays in a predictive model based on routine MRI characteristics. The purpose of this study was to explore the value of TA in distinguishing between benign and malignant NME in premenopausal women. Methods Women in whom NME was histologically proven (n = 147) were enrolled (benign: 58; malignant: 89) was retrospective. Then, 102 and 45 patients were classified as the training and validation groups, respectively. Scanning sequences included Fat-suppressed T2-weighted and fat-suppressed contrast-enhanced T1-weighted which were acquired on a 1.5T MRI system. Clinical and routine MR characteristics (CRMC) were evaluated by two radiologists according to the Breast Imaging and Reporting and Data system (2013). Texture features were extracted from all post-contrast sequences in the training group. The combination model was built and then assessed in the validation group. Pearson’s chi-square test and Mann–Whitney U test were used to compare categorical variables and continuous variables, respectively. Logistic regression analysis and receiver operating characteristic curve were employed to assess the diagnostic performance of CRMC, TA, and their combination model in NME diagnosis. Results The combination model showed superior diagnostic performance in differentiating between benign and malignant NME compared to that of CRMC or TA alone (AUC, 0.887 vs 0.832 vs 0.74). Moreover, compared to CRMC, the model showed high specificity (72.5% vs 80%). The results obtained in the validation group confirmed the model was promising. Conclusions With the combined use of TA and CRMC could afford an improved diagnostic performance in differentiating between benign and malignant NME.


2021 ◽  
Vol 11 ◽  
Author(s):  
Shi Yun Sun ◽  
Yingying Ding ◽  
Zhuolin Li ◽  
Lisha Nie ◽  
Chengde Liao ◽  
...  

ObjectivesTo evaluate the value of synthetic magnetic resonance imaging (syMRI), diffusion-weighted imaging (DWI), DCE-MRI, and clinical features in breast imaging–reporting and data system (BI-RADS) 4 lesions, and develop an efficient method to help patients avoid unnecessary biopsy.MethodsA total of 75 patients with breast diseases classified as BI-RADS 4 (45 with malignant lesions and 30 with benign lesions) were prospectively enrolled in this study. T1-weighted imaging (T1WI), T2WI, DWI, and syMRI were performed at 3.0 T. Relaxation time (T1 and T2), apparent diffusion coefficient (ADC), conventional MRI features, and clinical features were assessed. “T” represents the relaxation time value of the region of interest pre-contrast scanning, and “T+” represents the value post-contrast scanning. The rate of change in the T value between pre- and post-contrast scanning was represented by ΔT%.ResultsΔT1%, T2, ADC, age, body mass index (BMI), menopause, irregular margins, and heterogeneous internal enhancement pattern were significantly associated with a breast cancer diagnosis in the multivariable logistic regression analysis. Based on the above parameters, four models were established: model 1 (BI-RADS model, including all conventional MRI features recommended by BI-RADS lexicon), model 2 (relaxation time model, including ΔT1% and T2), model 3 [multi-parameter (mp)MRI model, including ΔT1%, T2, ADC, margin, and internal enhancement pattern], and model 4 (combined image and clinical model, including ΔT1%, T2, ADC, margin, internal enhancement pattern, age, BMI, and menopausal state). Among these, model 4 has the best diagnostic performance, followed by models 3, 2, and 1.ConclusionsThe mpMRI model with DCE-MRI, DWI, and syMRI is a robust tool for evaluating the malignancies in BI-RADS 4 lesions. The clinical features could further improve the diagnostic performance of the model.


2021 ◽  
pp. 197140092199076
Author(s):  
Sarv Priya ◽  
Amit Agarwal ◽  
Caitlin Ward ◽  
Thomas Locke ◽  
Varun Monga ◽  
...  

Objective Magnetic resonance texture analysis (MRTA) is a relatively new technique that can be a valuable addition to clinical and imaging parameters in predicting prognosis. In the present study, we investigated the efficacy of MRTA for glioblastoma survival using T1 contrast-enhanced (CE) images for texture analysis. Methods We evaluated the diagnostic performance of multiple machine learning models based on first-order histogram statistical parameters derived from T1-weighted CE images in the survival stratification of glioblastoma multiforme (GBM). Retrospective evaluation of 85 patients with GBM was performed. Thirty-six first-order texture parameters at six spatial scale filters (SSF) were extracted on the T1 CE axial images for the whole tumor using commercially available research software. Several machine learning classification models (in four broad categories: linear, penalized linear, non-linear, and ensemble classifiers) were evaluated to assess the survival prediction performance using optimal features. Principal component analysis was used prior to fitting the linear classifiers in order to reduce the dimensionality of the feature inputs. Fivefold cross-validation was used to partition the data iteratively into training and testing sets. The area under the receiver operating characteristic curve (AUC) was used to assess the diagnostic performance. Results The neural network model was the highest performing model with the highest observed AUC (0.811) and cross-validated AUC (0.71). The most important variable was the age at diagnosis, with mean and mean of positive pixels (MPP) for SSF = 0 being the second and third most important, followed by skewness for SSF = 0 and SSF = 4. Conclusions First-order texture features, when combined with age at presentation, show good accuracy in predicting GBM survival.


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Bollache ◽  
AT Huber ◽  
J Lamy ◽  
E Afari ◽  
TM Bacoyannis ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background. Recent studies revealed the ability of MRI T1 mapping to characterize myocardial involvement in both idiopathic inflammatory myopathy (IIM) and acute viral myocarditis (AVM), as compared to healthy controls. However, neither myocardial T1 nor T2 maps were able to discriminate between IIM and AVM patients, when considering conventional myocardial mean values and derived indices such as lambda and extracellular volume. Purpose. To investigate the ability of T1 mapping-derived texture analysis to differentiate IIM from AVM. Methods. Forty patients, 20 with IIM (51 ± 17 years, 9 men) and 20 with AVM (34 ± 13 years, 16 men) underwent 1.5T MRI T1 mapping using a modified Look-Locker inversion-recovery sequence before and 15 minutes after injection of a gadolinium contrast agent. After manual delineation of endocardial and epicardial borders and co-registration of all inversion time images, native and post-contrast T1 maps were estimated. Myocardial texture analysis was performed on native T1 maps. Textural features such as: autocorrelation, contrast, dissimilarity, energy and sum entropy were used to build a least squares-based linear regression model. Finally, receiver operating characteristic (ROC) analysis was used to investigate the ability of such texture features score to classify IIM vs. AVM patients, compared to the performance of mean myocardial T1. A Wilcoxon rank-sum test was also used to test difference significance between groups. Results. Both native and post-contrast mean myocardial T1 values were comparable between IIM (native: 1022 ± 43 ms; post-contrast: 319 ± 44 ms) and AVM (1056 ± 59 ms, p = 0.07; 318 ± 35 ms, p = 0.90, respectively) groups. Results of ROC analyses are provided in the Table, indicating that a better discrimination between IIM and AVM patients was obtained when using texture features, with higher AUC and accuracy than mean T1 values (Figure). Conclusion. Texture analysis derived from MRI T1 maps without contrast agent injection was able to discriminate between IIM and AVM with higher accuracy, sensitivity and specificity than conventional T1 indices. Such analysis could provide a useful myocardial signature to help diagnose and manage cardiac alterations associated with IIM in patients presenting with myocarditis and primarily suspected of AVM. Table Area under curve (AUC) Accuracy Sensitivity Specificity Native T1 0.67 0.70 0.65 0.75 Post-contrast T1 0.49 0.60 0.25 0.95 Texture features score 0.85 0.82 0.90 0.75 ROC analyses for classification between IIM and AVM patients Abstract Figure


Author(s):  
Diana L. Lam ◽  
Habib Rahbar

Breast cancer presents on MRI as an enhancing finding on post-contrast T1-weighted images that is distinct from normal background parenchymal enhancement (BPE), and these enhancing lesions can be further described as a focus, mass, or non-mass enhancement (NME). Each enhancing lesion, with the exception of a focus, can be described further with specific morphological features that are defined by the ACR BI-RADS Atlas. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations of a focus of enhancement and non-mass enhancement on MRI. Topics discussed include distinguishing a focus from normal BPE, benign versus suspicious features of a focus, NME characterization, and kinetic enhancement curves.


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