XXXX : Diffusion Kurtosis MR Imaging-Diagnostic Accuracy and Correlation with Clinical-Pathologic Factors.

@entity1 @entity0 @entity5 @entity1558
UNASSIGNED: Purpose To assess diagnostic accuracy with diffusion kurtosis imaging (DKI) in @entity1 with @entity1558 and to evaluate the potential association between DKI-derived parameters and @entity0 clinical-pathologic factors. Materials and Methods Institutional review board approval and written informed consent were obtained. Data from 97 @entity1 (mean age    standard deviation, 45.7 years    13.1; range, 19-70 years) with 98 lesions (57 malignant and 41 benign) who were treated between January 2014 and April 2014 were retrospectively analyzed. DKI (with b values of 0-2800 sec/mm(2)) and conventional diffusion-weighted imaging data were acquired. Kurtosis and diffusion coefficients from DKI and apparent diffusion coefficients from diffusion-weighted imaging were measured by two radiologists. Student t test, Wilcoxon signed-rank test, Jonckheere-Terpstra test, receiver operating characteristic curves, and Spearman correlation were used for statistical analysis. Results Kurtosis coefficients were significantly higher in the malignant lesions than in the benign lesions (1.05    0.22 vs 0.65    0.11, respectively; P < .0001). Diffusivity and apparent diffusion coefficients in the malignant lesions were significantly lower than those in the benign lesions (1.13    0.27 vs 1.97    0.33 and 1.02    0.18 vs 1.48    0.33, respectively; P < .0001). Significantly higher specificity for differentiation of malignant from benign lesions was shown with the use of kurtosis and diffusivity coefficients than with the use of apparent diffusion coefficients (83% [34 of 41] and 83% [34 of 41] vs 76% [31 of 41], respectively; P < .0001) with equal sensitivity (95% [54 of 57]). In @entity1 with invasive @entity0 , kurtosis was positively correlated with @entity5 histologic grade (r = 0.75) and expression of the Ki-67 protein (r = 0.55). Diffusivity was negatively correlated with @entity5 histologic grades (r = -0.44) and Ki-67 expression (r = -0.46). Conclusion DKI showed higher specificity than did conventional diffusion-weighted imaging for assessment of benign and malignant @entity1558 . @entity1 with grade 3 @entity0 or @entity5 with high expression of Ki-67 were associated with higher kurtosis and lower diffusivity coefficients; however, this association must be confirmed in prospective studies. (  ) RSNA, 2015 Online supplemental material is available for this article.
