Performance evaluation of texture analysis based on kinetic parametric maps from breast DCE-MRI in classifying benign from malignant lesions

BACKGROUND AND OBJECTIVES To investigate the performance of texture analysis based on enhancement kinetic parametric maps derived from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in discriminating benign from malignant tumors. METHODS A total of 192 cases confirmed by histopathology were retrospectively selected from our Picture Archiving and Communication System, including 93 benign and 99 malignant tumors. Lesion areas were delineated semi-automatically, and six kinetic parametric maps reflecting the perfusion information were generated, namely the maximum slope of increase (MSI), slope of signal intensity (SIslope ), initial percentage of peak enhancement (Einitial ), percentage of peak enhancement (Epeak ), early signal enhancement ratio (ESER), and second enhancement percentage (SEP) maps. A total of 286 texture features were extracted from those quantitative parametric maps. The Student t test or Mann-Whitney U test was used to select features that were statistically significantly different between the benign and malignant groups. A support vector machine was employed with a leave-one-out cross-validation method to establish the classification model. Classification performance was evaluated according to the receiver operating characteristic (ROC) theory. RESULTS The areas under ROC curves (AUCs) indicating the diagnostic performance were 0.925 for MSI, 0.854 for SIslope , 0.756 for Einitial , 0.923 for Epeak , 0.871 for ESER and 0.881 for SEP. Significant differences in AUCs were found between Einitial vs MSI, Einitial vs Epeak and Einitial vs SEP (P