Clinical Efficacy of Ultrafast Dynamic Contrast-Enhanced MRI Using Compressed Sensing in Distinguishing Benign and Malignant Soft-Tissue Tumors

Objective: To evaluate the clinical efficacy of ultrafast dynamic contrast-enhanced (DCE)-MRI using a compressed sensing (CS) technique for differentiating benign and malignant soft-tissue tumors (STTs) and to evaluate the factors related to the grading of malignant STTs.

Materials and methods: A total of 165 patients (96 male; mean age, 61 years), comprising 111 with malignant STTs and 54 with benign STTs according to the 2020 WHO classification, underwent DCE-MRI with CS between June 2018 and June 2023. The clinical, qualitative, and quantitative parameters associated with conventional MRI were also obtained. During post-processing of the early arterial phase of DCE-MRI, the time-to-enhance (TTE), time-to-peak (TTP), initial area under the curve at 60 s (iAUC60), and maximum slope were calculated. Furthermore, the delayed arterial phase parameters of DCE-MRI, including K^trans, K_ep, V_e, and iAUC values and time-concentration curve (TCC) types, were determined. Clinical and MRI parameters were statistically analyzed to differentiate between benign and malignant tumors and their correlation with tumor grading.

Results: According to logistic regression analysis, the TTE value (P < 0.001) of the early arterial phase and V_e (P = 0.039) and iAUC (P = 0.006) values of the delayed arterial phase, as well as age, location, peritumoral edema, and contrast heterogeneity on conventional MRI, were significant (P = 0.001-0.015) in differentiating benign and malignant tumors. Among all the quantitative parameters, the TTE value had the highest accuracy, with an area under the receiver operating characteristic curve of 0.902. The grading of malignant tumors was significantly correlated with peritumoral edema; CE heterogeneity; visual diffusion restriction; minimum and mean ADC; TTP, K_ep, and V_e values; and the TCC graph (all P < 0.05).

Conclusion: Among the quantitative parameters obtained using ultrafast DCE-MRI, early arterial phase TTE was the most accurate for distinguishing between benign and malignant tumors.