Oxford University Press
Journal of Breast Imaging
,  volume 3 ,  issue 1 ,  pages 44-56

Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702)

Jennifer G. Whisenant 1, 2
, 
Justin Romanoff 3
, 
Habib Rahbar 4
, 
Averi E. Kitsch 4
, 
Sara Harvey 5
, 
Linda Moy 6
, 
Wendy B. DeMartini 7
, 
Basak E. Dogan 8
, 
Wei T. Yang 9
, 
Lilian C. Wang 10
, 
Bonnie N. Joe 11
, 
Lisa J. Wilmes 11
, 
Nola M Hylton 11
, 
Karen Y. Oh 12
, 
L. A. Tudorica 12
, 
Colleen H. Neal 13
, 
Dariya Malyarenko 13
, 
Elizabeth S. McDonald 14
, 
CHRISTOPHER E. COMSTOCK 15
, 
Thomas E. Yankeelov 16
, 
Thomas L. Chenevert 13
, 
Savannah C. Partridge 4
1
 
2
 
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4
 
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7
 
8
 
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10
 
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Publication type: Journal Article
Publication date: 2020-12-24
Oxford University Press
scimago Q2
wos Q3
SJR: 0.658
CiteScore: 3.8
Impact factor: 2.0
ISSN: 26316110, 26316129
DOI:  10.1093/jbi/wbaa103
PubMed ID:  33543122
Radiological and Ultrasound Technology
Radiology, Nuclear Medicine and imaging
Abstract
Objective

The A6702 multisite trial confirmed that apparent diffusion coefficient (ADC) measures can improve breast MRI accuracy and reduce unnecessary biopsies, but also found that technical issues rendered many lesions non-evaluable on diffusion-weighted imaging (DWI). This secondary analysis investigated factors affecting lesion evaluability and impact on diagnostic performance.

Methods

The A6702 protocol was IRB-approved at 10 institutions; participants provided informed consent. In total, 103 women with 142 MRI-detected breast lesions (BI-RADS assessment category 3, 4, or 5) completed the study. DWI was acquired at 1.5T and 3T using a four b-value, echo-planar imaging sequence. Scans were reviewed for multiple quality factors (artifacts, signal-to-noise, misregistration, and fat suppression); lesions were considered non-evaluable if there was low confidence in ADC measurement. Associations of lesion evaluability with imaging and lesion characteristics were determined. Areas under the receiver operating characteristic curves (AUCs) were compared using bootstrapping.

Results

Thirty percent (42/142) of lesions were non-evaluable on DWI; 23% (32/142) with image quality issues, 7% (10/142) with conspicuity and/or localization issues. Misregistration was the only factor associated with non-evaluability (P = 0.001). Smaller (≤10 mm) lesions were more commonly non-evaluable than larger lesions (p <0.03), though not significant after multiplicity correction. The AUC for differentiating benign and malignant lesions increased after excluding non-evaluable lesions, from 0.61 (95% CI: 0.50–0.71) to 0.75 (95% CI: 0.65–0.84).

Conclusion

Image quality remains a technical challenge in breast DWI, particularly for smaller lesions. Protocol optimization and advanced acquisition and post-processing techniques would help to improve clinical utility.

Found 
Found 
2 citations
Akhmad Ekaterina
44 publications,  148 citations
h-index: 7
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
2 citations
Vasilev Yuriy
🤝
PhD in Health sciences
88 publications,  205 citations
h-index: 7
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
Research interests
Inteligencia artificial
Medicine
Radiation diagnostics
2 citations
Semenov Dmitry
PhD in Engineering
53 publications,  102 citations
h-index: 5
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
2 citations
Cherkasskaya Marina
PhD in Engineering
6 publications
h-index: 0
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department
Research interests
Electroforming
Fabric-limiting materials
Hydrogels
Polymer science

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GOST Copy
Whisenant J. G. et al. Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702) // Journal of Breast Imaging. 2020. Vol. 3. No. 1. pp. 44-56.
GOST all authors (up to 50) Copy
Whisenant J. G., Romanoff J., Rahbar H., Kitsch A. E., Harvey S., Moy L., DeMartini W. B., Dogan B. E., Yang W. T., Wang L. C., Joe B. N., Wilmes L. J., Hylton N. M., Oh K. Y., Tudorica L. A., Neal C. H., Malyarenko D., McDonald E. S., COMSTOCK C. E., Yankeelov T. E., Chenevert T. L., Partridge S. C. Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702) // Journal of Breast Imaging. 2020. Vol. 3. No. 1. pp. 44-56.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1093/jbi/wbaa103
UR - https://doi.org/10.1093/jbi/wbaa103
TI - Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702)
T2 - Journal of Breast Imaging
AU - Whisenant, Jennifer G.
AU - Romanoff, Justin
AU - Rahbar, Habib
AU - Kitsch, Averi E.
AU - Harvey, Sara
AU - Moy, Linda
AU - DeMartini, Wendy B.
AU - Dogan, Basak E.
AU - Yang, Wei T.
AU - Wang, Lilian C.
AU - Joe, Bonnie N.
AU - Wilmes, Lisa J.
AU - Hylton, Nola M
AU - Oh, Karen Y.
AU - Tudorica, L. A.
AU - Neal, Colleen H.
AU - Malyarenko, Dariya
AU - McDonald, Elizabeth S.
AU - COMSTOCK, CHRISTOPHER E.
AU - Yankeelov, Thomas E.
AU - Chenevert, Thomas L.
AU - Partridge, Savannah C.
PY - 2020
DA - 2020/12/24
PB - Oxford University Press
SP - 44-56
IS - 1
VL - 3
PMID - 33543122
SN - 2631-6110
SN - 2631-6129
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2020_Whisenant,
author = {Jennifer G. Whisenant and Justin Romanoff and Habib Rahbar and Averi E. Kitsch and Sara Harvey and Linda Moy and Wendy B. DeMartini and Basak E. Dogan and Wei T. Yang and Lilian C. Wang and Bonnie N. Joe and Lisa J. Wilmes and Nola M Hylton and Karen Y. Oh and L. A. Tudorica and Colleen H. Neal and Dariya Malyarenko and Elizabeth S. McDonald and CHRISTOPHER E. COMSTOCK and Thomas E. Yankeelov and Thomas L. Chenevert and Savannah C. Partridge},
title = {Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702)},
journal = {Journal of Breast Imaging},
year = {2020},
volume = {3},
publisher = {Oxford University Press},
month = {dec},
url = {https://doi.org/10.1093/jbi/wbaa103},
number = {1},
pages = {44--56},
doi = {10.1093/jbi/wbaa103}
}
MLA
Cite this
MLA Copy
Whisenant, Jennifer G., et al. “Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702).” Journal of Breast Imaging, vol. 3, no. 1, Dec. 2020, pp. 44-56. https://doi.org/10.1093/jbi/wbaa103.