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

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. material 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 mr scanner (siemens® magnetom avanto®). 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. 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 for breast cancer with high sensitivity. considering adc values along with dw-mri increased its detection rates and hence both can be incorporated as supplementary techniques in multiparametric mrm.