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Application value of IDEAL-IQ sequence in differential diagnosis of benign and malignant breast masses
YU Jiaping  DU Siyao  HAN Rui  ZHAO Ruimeng  ZHANG Lina 

Cite this article as: YU J P, DU S Y, HAN R, et al. Application value of IDEAL-IQ sequence in differential diagnosis of benign and malignant breast masses[J]. Chin J Magn Reson Imaging, 2024, 15(1): 14-20, 42. DOI:10.12015/issn.1674-8034.2024.01.003.


[Abstract] Objective To investigate the diagnostic significance of R2* values obtained from iterative decomposition of water and fat with echo asymmetrical and least-squares estimation quantitation sequence (IDEAL-IQ) in distinguishing between benign and malignant breast tumors, and compare these values with those obtained from traditional multiple echo T2* gradient recalled echo (GRE) series.Materials and Methods A total of 50 cases of benign tumors in 42 patients admitted to the First Hospital of China Medical University from September 2021 to October 2023 were retrospectively analyzed. The propensity score matching was used to match the longest diameter of the largest plane of the tumor in picture archiving and communication systems (PACS), and 150 cases of malignant tumors in 150 patients were included according to the 1∶3 ratio. Malignant tumors were grouped based on the positive/negative expression of prognostic factors such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2). All patients underwent multi-parameter MRI with IDEAL-IQ and multi-echo T2* GRE sequences, and the following quantitative parameters were measured: R2* IDEAL from IDEAL-IQ sequence, R2* GRE from multi-echo T2* GRE sequence, apparent diffusion coefficient (ADC), and tumor diameter. The intra-class correlation coefficient (ICC) was used to evaluate the consistency between the researchers. Depending on the type of raw data, the differences of each parameter were compared and analyzed using one-way analysis (independent samples t-test, Mann-Whitney U-test, etc.). Spearman correlation analysis was used to analyze the correlation between R2* IDEAL and R2* GRE, as well as their correlation with ADC. The difference between R2* IDEAL and R2* GRE was compared by paired sample t-test. A joint diagnostic model was established by using logistic regression analysis, and the receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to analyze the efficacy of single and combined parameters in differentiating benign and malignant breast tumors.Results Correlation analysis showed that R2* IDEAL and R2* GRE in patients with breast tumors were moderately strongly correlated (r=0.763, P<0.001), and both were weakly negatively correlated with ADC values [r=-0.300 (R2* IDEAL), -0.306 (R2* GRE), P<0.001]. In benign group and malignant group, R2* IDEAL and R2* GRE showed moderate correlation (r=0.745, 0.680, P<0.001), and there was no correlation between them and ADC. The R2* values obtained by the two sequences were statistically different (P<0.05). There was a significant difference in R2* IDEAL between benign and malignant groups (P<0.001), and the R2* value of luminal HER-2 negative group was the highest. For a single parameter, ADC value had the largest AUC (0.857) in differentiating benign and malignant groups. For the combined parameters, R2* IDEAL+ADC had the largest AUC (0.927) in differentiating benign group from luminal negative group. The differences were statistically significant (P<0.05).Conclusions The R2* value generated by IDEAL-IQ sequence can be used to distinguish benign and malignant breast tumors, and may be another non-contrast parameter in addition to ADC to assist the differentiation of benign and malignant breast tumors.
[Keywords] breast neoplasms；distinguish between benign and malignant；molecular subtype；iterative decomposition of water and fat with echo asymmetrical and least-squares estimation quantitation sequence；diffusion weighted imaging；magnetic resonance imaging

YU Jiaping1   DU Siyao1   HAN Rui2   ZHAO Ruimeng1   ZHANG Lina1*  

1 Department of Radiology, the First Hospital of China Medical University, Shenyang 110001, China

2 The First Clinical College, China Medical University, Shenyang 110001, China

Corresponding author: ZHANG L N, E-mail: zhanglnda@163.com

Conflicts of interest   None.

Received  2023-08-30
Accepted  2023-12-29
DOI: 10.12015/issn.1674-8034.2024.01.003
Cite this article as: YU J P, DU S Y, HAN R, et al. Application value of IDEAL-IQ sequence in differential diagnosis of benign and malignant breast masses[J]. Chin J Magn Reson Imaging, 2024, 15(1): 14-20, 42. DOI:10.12015/issn.1674-8034.2024.01.003.

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