• Zhiwei Li, Tao Ai, Yiqi Hu, Xu Yan, Marcel Dominik Nickel, Xiao Xu, and Liming Xia.
• Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
• J Magn Reson Imaging. 2018 Jan 1; 47 (1): 91-96.

PurposeTo investigate the application of whole-lesion histogram analysis of pharmacokinetic parameters for differentiating malignant from benign breast lesions on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Materials And MethodsIn all, 92 women with 97 breast lesions (26 benign and 71 malignant lesions) were enrolled in this study. Patients underwent dynamic breast MRI at 3T using a prototypical CAIPIRINHA-Dixon-TWIST-VIBE (CDT-VIBE) sequence and a subsequent surgery or biopsy. Inflow rate of the agent between plasma and interstitium (Ktrans ), outflow rate of agent between interstitium and plasma (Kep ), extravascular space volume per unit volume of tissue (ve ) including mean value, 25th/50th/75th/90th percentiles, skewness, and kurtosis were then calculated based on the whole lesion. A single-sample Kolmogorov-Smirnov test, paired t-test, and receiver operating characteristic curve (ROC) analysis were used for statistical analysis.ResultsMalignant breast lesions had significantly higher Ktrans , Kep , and lower ve in mean values, 25th/50th/75th/90th percentiles, and significantly higher skewness of ve than benign breast lesions (all P < 0.05). There was no significant difference in kurtosis values between malignant and benign breast lesions (all P > 0.05). The 90th percentile of Ktrans , the 90th percentile of Kep , and the 50th percentile of ve showed the greatest areas under the ROC curve (AUC) for each pharmacokinetic parameter derived from DCE-MRI. The 90th percentile of Kep achieved the highest AUC value (0.927) among all histogram-derived values.ConclusionThe whole-lesion histogram analysis of pharmacokinetic parameters can improve the diagnostic accuracy of breast DCE-MRI with the CDT-VIBE technique. The 90th percentile of Kep may be the best indicator in differentiation between malignant and benign breast lesions.Level Of Evidence4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2018;47:91-96.© 2017 International Society for Magnetic Resonance in Medicine.

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