Image quality and whole-lesion histogram and texture analysis of diffusion-weighted imaging of breast MRI based on advanced ZOOMit and simultaneous multislice readout-segmented echo-planar imaging.

Objectives: To investigate the image quality and diagnostic capability a of whole-lesion histogram and texture analysis of advanced ZOOMit (A-ZOOMit) and simultaneous multislice readout-segmented echo-planar imaging (SMS-RS-EPI) to differentiate benign from malignant breast lesions.

Study Design: From February 2020 to October 2020, diffusion-weighted imaging (DWI) using SMS-RS-EPI and A-ZOOMit were performed on 167 patients. Three breast radiologists independently ranked the image datasets. The inter-/intracorrelation coefficients (ICCs) of mean image quality scores and lesion conspicuity scores were calculated between these three readers. Histogram and texture features were extracted from the apparent diffusion coefficient (ADC) maps, respectively, based on a WL analysis. Student's t-tests, one-way ANOVAs, Mann-Whitney U tests, and receiver operating characteristic curves were used for statistical analysis.

Results: The overall image quality scores and lesion conspicuity scores for A-ZOOMit and SMS-RS-EPI showed statistically significant differences (4.92 ± 0.27 . 3.92 ± 0.42 and 4.93 ± 0.29 . 3.87 ± 0.47, < 0.0001). The ICCs for the image quality and lesion conspicuity scores had good agreements among the three readers (all ICCs >0.75). To differentiate benign and malignant breast lesions, the entropy of ADC had the highest area (0.78) under the ROC curve.

Conclusions: A-ZOOMit achieved higher image quality and lesion conspicuity than SMS-RS-EPI. Entropy based on A-ZOOMit is recommended for differentiating benign from malignant breast lesions.