The Evaluation of Combined Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion Diffusion Weighted Imaging in Preoperatively Predicting Sentinel Lymph Node Metastasis of Breast Cancer

Purpose

To evaluate the diagnostic performance of quantitative diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) parameters for preoperative, noninvasive detection of sentinel lymph node metastasis (SLNM) in breast cancer. Methods and materials: Clinicopathologic and MRI data from 61 patients with histologically confirmed breast cancer were reviewed, including 32 patients with SLNM and 29 without SLNM. All patients underwent multi-b-value diffusion-weighted imaging at 3.0 T. Images were analyzed using simplified DKI and biexponential IVIM models on the iCare SpinX workstation. Derived parameters included the diffusion coefficient D, kurtosis K, pseudodiffusion coefficient D*slow diffusion coefficient Dslow, and perfusion fraction f. Group differences were assessed using independent-samples t-tests and logistic regression. Diagnostic performance was evaluated using receiver operating characteristic analysis.