Predictive value of intravoxel incoherent motion combined with diffusion kurtosis imaging for breast cancer axillary lymph node metastasis: a retrospective study

Abstract

Background Non-invasive imaging technologies for assessing axillary lymph node (ALN) metastasis of breast cancer are needed in clinical practice. Purpose To explore the clinical value of intravoxel incoherent motion (IVIM) and diffusional kurtosis imaging (DKI) for predicting ALN metastasis of breast cancer. Material and Methods A total of 194 patients with pathologically confirmed breast cancer who underwent IVIM and DKI examination were reviewed retrospectively. The IVIM derived parameters of D, D*, and f and DKI-derived parameters of MD and MK were measured. The independent samples t-test was used to compare the parameters between the ALN metastasis and non-ALN metastasis groups. Receiver operating characteristic (ROC) curve analysis was also performed. Results The D and MD in the ALN metastasis group were significantly lower than those in the non-ALN metastasis group ( P < 0.001, P < 0.001). The D*, f, and MK were higher in the ALN metastasis group than in the non-ALN metastasis group ( P = 0.015, P  = 0.014, and P  = 0.001, respectively). The area under the ROC curve (AUC) of D (0.768) was highest. In addition, the diagnostic efficiency of both IVIM and DKI were higher than that of the conventional MRI ( P = 0.002, P = 0.048). The diagnostic efficiency of IVIM + DKI were higher than that of the IVIM or DKI alone ( P = 0.021, P = 0.004). Conclusion IVIM and DKI can be used for predicting breast cancer ALN metastasis with D as the most meaningful parameter.