The added value of qualitative and quantitative diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating benign from malignant breast lesions

Abstract

Objective: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) with calculation of the apparent diffusion coefficient (ADC) value in characterizing benign and malignant breast lesions. Patients and methods: The imaging data of thirty-nine female patients (mean age 48 years) who underwent breast MRI using conventional pulse sequences. DW-MRI and dynamic contrast enhanced (DCE) study were all analyzed and correlated with the results of histopathological evaluation. Results: Forty-six breast lesions were detected in the thirty-nine patients of the study. According to the histopathological analysis, there were 27 malignant lesions (58.69%) and 19 benign lesions (41.31%). The malignant lesions showed a mean ADC value of 0.93 ± 0.42 × 10−3 mm2/s. and the benign lesions showed a mean ADC value of 1.54 ± 0.43 × 10−3 mm2/s. The receiver operating characteristic (ROC) curve could identify an ADC 1.26 × 10−3 mm2/s as a cut-off value to differentiate between benign and malignant lesions with sensitivity and specificity of 89% and 94.7% respectively. Conclusion: DW-MRI is useful for differentiating malignant and benign breast lesions, increasing the specificity of breast MRI. DW-MRI doesn't cause significant increase in the total examination time and is recommended to be incorporated in the standard breast MRI protocol. Keywords: Breast MRI, Diffusion-weighted imaging, Apparent diffusion coefficient