Share：
Share this content in WeChat
X
[Chinese][PDF]2274
• Experience Exchang •
Value of MR pharmacokinetic perfusion scan in differential diagnosis between idiopathic granulomatous mastitis and invasive ductal carcinoma appearing as segmental distribution enhancement
CHEN Yan  WU Xiaoyan  ZHANG Min  HUANG Xuejing  CHENG Jianming  ZHENG Liyun 

Cite this article as: CHEN Y, WU X Y, ZHANG M, et al. Value of MR pharmacokinetic perfusion scan in differential diagnosis between idiopathic granulomatous mastitis and invasive ductal carcinoma appearing as segmental distribution enhancement[J]. Chin J Magn Reson Imaging, 2024, 15(3): 177-182. DOI:10.12015/issn.1674-8034.2024.03.028.


[Abstract] Objective To evaluate the differential diagnosis value of MR pharmacokinetic perfusion scan using compressed sense technique between idiopathic granulomatous mastitis (IGM) and invasive ductal carcinoma (IDC) appearing as non-mass enhancement with segmental distribution on MR.Material and Methods: A total of 42 non-mass enhanced breast lesions with segmental distribution on MR (IGM 27 cases, IDC 15 cases) were retrospectively analyzed. All cases were pathologically proved. Comparison of menstrual state, age, inner enhancement pattern, between two groups were made with Fisher's exact test, t test and Chi-square test. The t test and Mann Whitney U test were used to screen out the difference terms in the volume transfer constant (Ktrans), rate constant (Kep), extravascular space volume fraction and extracellular space volume fraction (Ve) between the two groups. Binary logistic linear regression was used to obtain the odds ratios (OR) of the parameter with significant difference and its receiver operating characteristic (ROC) curve was generated to evaluate the diagnostic value.Results There were significant differences in age and menstrual state between two groups (P=0.001, 0.003), while the difference in inner enhancement pattern was of no significant difference (P=0.883). MR pharmacokinetic perfusion scan: Ktrans(IGM) was (0.274±0.163) min-1, which was lower than Ktrans(IDC) (0.451±0.257) min-1. While Kep(IGM) (0.618±0.245) min-1 was higher than Kep(IDC) (0.856±0.420) min-1. Both differences of Ktrans and Kep between two groups were significant (P=0.013, 0.012). The Ve for two groups were Ve (IGM) (0.531±0.320) min-1 and Ve (IDC) (0.629±0.323) min-1. There was no significant difference in Ve between them (P=0.182). The OR value for Ktrans was 2.243 [95% confidence interval (CI): 0.652-6.294)] in logistic linear regression (P=0.021). The Jordan index (0.585), sensitivity (73.3%), specificity (85.2%) and area under the curve (AUC) (0.778, 95% CI: 0.623-0.891) were obtained from the ROC for Ktrans (P=0.001).Conclusions The parameter Ktrans derived from MR pharmacokinetic perfusion scan using compressed sense technique can be used to distinguish IGM from IDC, which appeare as non-mass enhancement with segmental distribution on MR.
[Keywords] idiopathic granulomatous mastitis；invasive ductal carcinoma；MR pharmacokinetic perfusion scan；compressed sense technique；magnetic resonance imaging

CHEN Yan1   WU Xiaoyan2*   ZHANG Min2   HUANG Xuejing2   CHENG Jianming2   ZHENG Liyun3  

1 Department of Radiology, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201900, China

2 Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

3 Shanghai United Imaging Healthcare Co., Ltd., Shanghai 201807, China

Corresponding author: WU X Y, E-mail: karin114@126.com

Conflicts of interest   None.

Received  2023-08-02
Accepted  2024-02-26
DOI: 10.12015/issn.1674-8034.2024.03.028
Cite this article as: CHEN Y, WU X Y, ZHANG M, et al. Value of MR pharmacokinetic perfusion scan in differential diagnosis between idiopathic granulomatous mastitis and invasive ductal carcinoma appearing as segmental distribution enhancement[J]. Chin J Magn Reson Imaging, 2024, 15(3): 177-182. DOI:10.12015/issn.1674-8034.2024.03.028.

[1]
SAYDAM M, YILMAZ K B, SAHIN M, et al. New findings on autoimmune etiology of idiopathic granulomatous mastitis: serum IL-17, IL-22 and IL-23 levels of patients[J]. J Invest Surg, 2021, 34(9): 993-997. DOI: 10.1080/08941939.2020.1725190.
[2]
ZHAO Q F, XIE T W, FU C X, et al. Differentiation between idiopathic granulomatous mastitis and invasive breast carcinoma, both presenting with non-mass enhancement without rim-enhanced masses: the value of whole-lesion histogram and texture analysis using apparent diffusion coefficient[J/OL]. Eur J Radiol, 2020, 123: 108782 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/31864142/. DOI: 10.1016/j.ejrad.2019.108782.
[3]
AZZAM M I, ALNAIMAT F, AL-NAZER M W, et al. Idiopathic granulomatous mastitis: clinical, histopathological, and radiological characteristics and management approaches[J]. Rheumatol Int, 2023, 43(10): 1859-1869. DOI: 10.1007/s00296-023-05375-6.
[4]
BARRETO D S, SEDGWICK E L, NAGI C S, et al. Granulomatous mastitis: etiology, imaging, pathology, treatment, and clinical findings[J]. Breast Cancer Res Treat, 2018, 171(3): 527-534. DOI: 10.1007/s10549-018-4870-3.
[5]
NGUYEN M H, MOLLAND J G, KENNEDY S, et al. Idiopathic granulomatous mastitis: case series and clinical review[J]. Intern Med J, 2021, 51(11): 1791-1797. DOI: 10.1111/imj.15112.
[6]
VELIDEDEOGLU M, KUNDAKTEPE B P, AKSAN H, et al. Preoperative fibrinogen and hematological indexes in the differential diagnosis of idiopathic granulomatous mastitis and breast cancer[J/OL]. Medicina, 2021, 57(7): 698 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/34356979/. DOI: 10.3390/medicina57070698.
[7]
SRIPATHI S, AYACHIT A, BALA A, et al. Idiopathic granulomatous mastitis: a diagnostic dilemma for the breast radiologist[J]. Insights Imaging, 2016, 7(4): 523-529. DOI: 10.1007/s13244-016-0497-2.
[8]
DURUR-SUBASI I. Diagnostic and interventional radiology in idiopathic granulomatous mastitis[J]. Eurasian J Med, 2019, 51(3): 293-297. DOI: 10.5152/eurasianjmed.2019.19211.
[9]
PLUGUEZ-TURULL C W, NANYES J E, QUINTERO C J, et al. Idiopathic granulomatous mastitis: manifestations at multimodality imaging and pitfalls[J]. Radiographics, 2018, 38(2): 330-356. DOI: 10.1148/rg.2018170095.
[10]
ILLMAN J E, TERRA S B, CLAPP A J, et al. Granulomatous diseases of the breast and axilla: radiological findings with pathological correlation[J]. Insights Imaging, 2018, 9(1): 59-71. DOI: 10.1007/s13244-017-0587-9.
[11]
MOHINDRA N, JAIN N, SABARETNAM M, et al. Mammography and digital breast tomosynthesis in granulomatous and nongranulomatous mastitis[J/OL]. J Surg Res, 2023, 281: 13-21 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/36108534/. DOI: 10.1016/j.jss.2022.08.009.
[12]
MARINO M A, AVENDANO D, SEVILIMEDU V, et al. Limited value of multiparametric MRI with dynamic contrast-enhanced and diffusion-weighted imaging in non-mass enhancing breast tumors[J/OL]. Eur J Radiol, 2022, 156: 110523 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/36122521/. DOI: 10.1016/j.ejrad.2022.110523.
[13]
QU N, LUO Y H, YU T. Differentiation between Clinically Noninflammatory Granulomatous Lobular Mastitis and Noncalcified Ductal Carcinoma in situ Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging[J]. Breast Care, 2020, 15(6): 619-627. DOI: 10.1159/000506068.
[14]
HASBAHCECI M, KADIOGLU H. Use of imaging for the diagnosis of idiopathic granulomatous mastitis: a clinician's perspective[J]. J Coll Physicians Surg Pak, 2018, 28(11): 862-867. DOI: 10.29271/jcpsp.2018.11.862.
[15]
VELIDEDEOGLU M, UMMAN V, KILIC F, et al. Idiopathic granulomatous mastitis: introducing a diagnostic algorithm based on 5years of follow-up of 152 cases from Turkey and a review of the literature[J]. Surg Today, 2022, 52(4): 668-680. DOI: 10.1007/s00595-021-02367-6.
[16]
LI T, YU T, LI L, et al. Use of diffusion kurtosis imaging and quantitative dynamic contrast-enhanced MRI for the differentiation of breast tumors[J]. J Magn Reson Imaging, 2018, 48(5): 1358-1366. DOI: 10.1002/jmri.26059.
[17]
TUDORICA A, OH K Y, CHUI S Y, et al. Early prediction and evaluation of breast cancer response to neoadjuvant chemotherapy using quantitative DCE-MRI[J]. Transl Oncol, 2016, 9(1): 8-17. DOI: 10.1016/j.tranon.2015.11.016.
[18]
CHANG L F, LAN H L. Effect of neoadjuvant chemotherapy on angiogenesis and cell proliferation of breast cancer evaluated by dynamic enhanced magnetic resonance imaging[J/OL]. Biomed Res Int, 2022, 2022: 3156093 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/35915805/. DOI: 10.1155/2022/3156093.
[19]
AYDIN H. The MRI characteristics of non-mass enhancement lesions of the breast: associations with malignancy[J/OL]. Br J Radiol, 2019, 92(1096): 20180464 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/30673299/. DOI: 10.1259/bjr.20180464.
[20]
DE FARIA CASTRO FLEURY E, CASTRO C, AMARAL M S C DO, et al. Management of non-mass enhancement at breast magnetic resonance in screening settings referred for magnetic resonance-guided biopsy[J/OL]. Breast Cancer, 2022, 16: 11782234221095897 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/35602239/. DOI: 10.1177/11782234221095897.
[21]
FENG L, BENKERT T, BLOCK K T, et al. Compressed sensing for body MRI[J]. J Magn Reson Imaging, 2017, 45(4): 966-987. DOI: 10.1002/jmri.25547.
[22]
CHAI Q H, SU G Q, NIE S D. Magnetic resonance partial K-space reconstruction algorithm[J]. Chin J Med Phys, 2018, 35(5): 537-542. DOI: 10.3969/j.issn.1005-202X.2018.05.008.
[23]
YUEN S, UEMATSU T, MASAKO K, et al. Segmental enhancement on breast MR images: differential diagnosis and diagnostic strategy[J]. Eur Radiol, 2008, 18(10): 2067-2075. DOI: 10.1007/s00330-008-0980-3.
[24]
GROVER H, GROVER S B, GOYAL P, et al. Clinical and imaging features of idiopathic granulomatous mastitis - The diagnostic challenges and a brief review[J/OL]. Clin Imaging, 2021, 69: 126-132 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/32717540/. DOI: 10.1016/j.clinimag.2020.06.022.
[25]
GOULABCHAND R, HAFIDI A, VAN DE PERRE P, et al. Mastitis in autoimmune diseases: review of the literature, diagnostic pathway, and pathophysiological key players[J/OL]. J Clin Med, 2020, 9(4): 958 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/32235676/. DOI: 10.3390/jcm9040958.
[26]
ALJAWDER A A A, LI J J X, NG J K M, et al. Idiopathic granulomatous mastitis and cystic neutrophilic granulomatous mastitis: two sides of the same coin or distinct entities?[J]. Pathology, 2023, 55(3): 335-341. DOI: 10.1016/j.pathol.2022.09.005.
[27]
MATICH A, SUD S, BUXI T B S, et al. Idiopathic granulomatous mastitis and its mimics on magnetic resonance imaging: a pictorial review of cases from India[J/OL]. J Clin Imaging Sci, 2020, 10: 53 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/33024608/. DOI: 10.25259/JCIS_112_2019.
[28]
ALAREF A, HASSAN A, SHARMA KANDEL R, et al. Magnetic resonance imaging features in different types of invasive breast cancer: a systematic review of the literature[J/OL]. Cureus, 2021, 13(3): e13854 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/33859904/. DOI: 10.7759/cureus.13854.
[29]
RAMADAN R, KORYEM I M, FAYED H. Idiopathic granulomatous mastitis: risk factors and management[J]. Breast Dis, 2022, 41(1): 413-420. DOI: 10.3233/BD-220047.
[30]
UCARYILMAZ H, KOKSAL H, EMSEN A, et al. The role of regulatory T and B cells in the etiopathogenesis of idiopathic granulomatous mastitis[J]. Immunol Invest, 2022, 51(2): 357-367. DOI: 10.1080/08820139.2020.1832114.
[31]
ALBAYRAK M G B, SIMSEK T, KASAP M, et al. Tissue proteome analysis revealed an association between cancer, immune system response, and the idiopathic granulomatous mastitis[J/OL]. Med Oncol, 2022, 39(12): 238 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/36175807/. DOI: 10.1007/s12032-022-01845-2.
[32]
AITKEN S L, CORL C M, SORDILLO L M. Immunopathology of mastitis: insights into disease recognition and resolution[J]. J Mammary Gland Biol Neoplasia, 2011, 16(4): 291-304. DOI: 10.1007/s10911-011-9230-4.
[33]
DOGAN S, DAL F, GULER M, et al. Is peripheral blood immunophenotyping useful to understand the etiology of Idiopathic Granulomatous?[J]. Hum Immunol, 2023, 84(5/6/7): 315-319. DOI: 10.1016/j.humimm.2023.05.001.
[34]
HUANG Y M, LO C, CHENG C F, et al. Serum C-reactive protein and interleukin-6 levels as biomarkers for disease severity and clinical outcomes in patients with idiopathic granulomatous mastitis[J/OL]. J Clin Med, 2021, 10(10): 2077 [2023-08-01]. https://pubmed.ncbi.nlm.nih.gov/34066203/. DOI: 10.3390/jcm10102077.
[35]
KIM Y, KIM S H, SONG B J, et al. Early prediction of response to neoadjuvant chemotherapy using dynamic contrast-enhanced MRI and ultrasound in breast cancer[J]. Korean J Radiol, 2018, 19(4): 682-691. DOI: 10.3348/kjr.2018.19.4.682.

PREV Application of neck imaging reporting and data systems in MRI diagnosis of early exclusive mucosal local recurrent nasopharyngeal carcinoma
NEXT The research based on clinical and MRI features for the risk factors of femoroacetabular impingement syndrome
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn