DWIBS: Can it replace DCE-MRI in detection and characterization of suspicious breast lesions?

Abstract

Objectives: Unenhanced MR imaging of the breast have recently been introduced. These include STIR, T2-weighted TSE and DWIBS sequences. These sequences could characterize breast lesions, although not yet able to avoid histological characterization. Materials and methods: The study included 46 patients referred to our radiology department at Ain shams university Hospital from March 2015 till May 2016. Sonomammography was routinely done to all patients. Only 29 patients out of the 46 were included in our MRI study after exclusion of BIRADS I & II patients on sono mammography. Interpretation was performed using an adapted BI-RADS system for both sono mammography results and MRI results. Statistical analysis was performed to show the efficacy of the added DWIBS technique in comparison to DCE-MRI. The final histopathological examination served as gold standard. Results: By DCE-MRI out of the 29 examined breast lesions, 15 (51.7%) were classified as malignant and 14 (48.3%) were benign. By non contrast study with the addition of DWIBS, patients were classified into16 (55.2%) malignant and 13 (44.8%) benign. Our histopathology results showed 14 (48.3%) malignant and 15 (51.7%) benign lesions. Thus the DWIBS had a sensitivity of 87.5% and a specificity of 86.7% while DCE-MRI had a higher sensitivity: 93.3% and specificity 93.3%. Conclusion: DWIBS is a promising MRI technique, with a specificity near to DCE-MRI, and a large potential for improving the clinical efficiency of classical MRM.

Keywords

• Breast cancer
• (MRM) magnetic resonance mammography
• (DWIBS) Diffusion weighted imaging with back ground suppression
• DCE MRI (dynamic contrast enhanced MRI)
• Sono mammography