Background Previous studies have indicated that amide proton transfer-weighted imaging (APTWI) could be utilized for differentiating benign and malignant tumors. The APTWI technology has increasingly being applied to breast tumor research in recent years. However, according to the latest literature retrieval, no relevant previous studies compared the value of APTWI and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in distinguishing benign lesions from malignant lesions. In the present study, the application of APTWI and DCE for differentiating the benign and malignant breast lesions was investigated. Patients and methods APTWI was performed on 40 patients (42 lesions) who were enrolled in this prospective study. The lesions were split into two groups, one with malignant breast lesions (n = 28) and the other with benign breast lesions (n = 14), based on the results of the histology. The measured image characteristics (APT value, apparent diffusion coefficient [ADC] value, and time-of-intensity-curve [TIC] type) were compared between the two groups, and the ROC curve was used to quantify the diagnostic performance on the basis of these factors. The correlation between the APT values and the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 expression levels and histological grades was examined using Spearman's correlation coefficient. Results The measured APT and ADC values showed a strong inter-observer agreement according to the intraclass correlation coefficients (0.954 and 0.825). Compared to benign lesions, malignant lesions had significantly higher APT values (3.18 ± 1.07 and 2.01 ± 0.51, p < 0.001). Based on APTWI, DCE, diffusion-weighted imaging (DWI), and ADC + APTWI, ADC + DCE, and DCE + APTWI, the area-under-the-curve values were 0.915, 0.815, 0.878, 0.921, 0.916, and 0.936, respectively. Conclusions APTWI is a potentially promising method in differentiating benign and malignant breast lesions, and may it become a great substitute for DCE examination in the future.

中文翻译：

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使用酰胺质子转移加权成像和动态对比增强磁共振成像评估乳腺病变

背景既往研究表明酰胺质子转移加权成像（APTWI）可用于区分良性和恶性肿瘤。近年来，APTWI技术越来越多地应用于乳腺肿瘤研究。但根据最新文献检索，既往没有相关研究比较APTWI和动态对比增强（DCE）磁共振成像（MRI）在区分良性病变和恶性病变方面的价值。本研究探讨了APTWI和DCE在鉴别乳腺良恶性病变中的应用。患者和方法 对参加本前瞻性研究的 40 名患者（42 个病灶）进行了 APTWI。根据组织学结果，将病变分为两组，一组为恶性乳腺病变（n = 28），另一组为良性乳腺病变（n = 14）。比较两组测量的图像特征（APT值、表观扩散系数[ADC]值和时间强度曲线[TIC]类型），并在此基础上使用ROC曲线量化诊断性能这些因素。使用 Spearman 相关系数检查 APT 值与雌激素受体 (ER)、孕激素受体 (PR)、人表皮生长因子受体 2 (HER-2) 和 Ki-67 表达水平和组织学分级之间的相关性。结果 根据组内相关系数（0.954 和 0.825），测量的 APT 和 ADC 值显示出很强的观察者间一致性。与良性病变相比，恶性病变的 APT 值显着较高（3.18 ± 1.07 和 2.01 ± 0.51，p < 0.001）。基于 APTWI、DCE、弥散加权成像 (DWI) 以及 ADC + APTWI、ADC + DCE 和 DCE + APTWI，曲线下面积值为 0.915、0.815、0.878、0.921、0.916 和 0.936 ， 分别。结论 APTWI 是一种有潜力的鉴别乳腺良恶性病变的方法，未来有望成为 DCE 检查的重要替代品。