Predictive value of ADC mapping in discriminating probably benign and suspicious breast lesions

Abstract

Purpose: The purpose of this study was to evaluate the usefulness of apparent diffusion coefficient (ADC value) in differentiating between probably benign breast lesions and, suspicious lesions (ACR-BIRADS categories 3 and 4 respectively). Patients and methods: Breast lesions meeting study criteria were identified on dynamic contrast enhanced (DCE)-MRI examinations in 48 women over the course of the study period for 2 years. We found 27 (56.2%) of the cases probably benign as their BIRADS category 3 and the remaining 21 (43.7%) cases were category 4. Images were obtained with diffusion sensitizing gradients of 0 and 750 mm2/s. The apparent diffusion coefficient (ADC) was calculated and correlated with the histological data. Results: The ADC values recorded a sensitivity of 97.9% and a specificity of 80%. The positive predictive value was 95.7% in differentiation between the benign and suspicious breast lesions. The difference in mean ADC for benign breast lesions (BIRADS-3, 1.45 ± 0.46 × 10−3 mm2/s), and suspicious lesions (BIRADS-4, 1.06 ± 0.56 × 10−3 mm2/s) was statistically significant. Conclusion: Including the ADC diffusion coefficient in the diagnostic work up of patients with indeterminate breast lesions can help in the differentiation between benign and malignant breast lesions.

Keywords

• Diffusion-weighted imaging (DWI)
• Apparent diffusion coefficient value (ADC)
• American College of Radiology
• Breast imaging reporting and data system (ACR-BIRADS)