Role of diffusion weighted imaging with corresponding apparent diffusion coefficient values in differentiating benign and malignant breast lesions

Document Type : Original Paper

Authors

1 Department of Radiodiagnosis, Sri Devraj Urs Medical College, Kolar

2 Professor & HOD, Department of radiodiagnosis, SDUMC

3 Department of Radiodiagnosis, Sri Devaraj Urs Medical College, Kolar

Abstract

Introduction: The objective of this study is to assess the role of diffusion weighted (DW) magnetic resonance imaging (MRI) along with its corresponding apparent diffusion coefficient (ADC) values in differentiating malignant from benign breast lesions.



Materials and Methods: Patients with breast lesions and those who met inclusion and exclusion criteria were included in this study. MR Mammography (MRM) was performed on 1.5 Tesla, 18 channel, MR Scanner (Siemens® Magnetom Avanto®) using dedicated double breast coil. DWI was performed at b-values of 50, 400 and 800 s/mm2 followed by ADC sequence.



Results: 50 patients with a total of 81 breast lesions and whose diagnosis was histopathologically confirmed following MRM were included in the study. We observed that benign lesions showed no restricted diffusion with an ADC value of >1.3 x 10-3 mm2/s. Most of the malignant lesions showed restricted diffusion with ADC value of < 1.3 10-3 mm2/s. A non-malignant condition, Benign Phyllodes tumor (n=1) showed no restricted diffusion but had a low ADC of 1.1 x 10-3 giving false positive result. Mucinous carcinomas (n=5) showed no restricted diffusion and had a mean ADC value of >1.3 x 10-3; thereby increasing false negative results. We observed sensitivity of DWI along with ADC value to be 86.8% and specificity as 97.6%.



Conclusion: DW-MRI can be employed as a fast unenhanced screening modality. Sensitivity is superior to that of X-ray mammography and ultrasound. The ability of DW-MRI to detect cancer may further be enhanced using ADC values. Both DW-MRI and ADC values can be incorporated as supplementary techniques into multiparametric MRM for more accurate diagnosis.

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Articles in Press, Accepted Manuscript
Available Online from 31 January 2022
  • Receive Date: 13 October 2021
  • Revise Date: 19 January 2022
  • Accept Date: 31 January 2022
  • First Publish Date: 31 January 2022