Value of diffusion weighted imaging (DWI) and apparent diffusion coefficient factor (ADC) calculation in differentiation of solid breast lesions

Abstract

Objective To study the utility of DWI and ADC in increasing the specificity of MRI in differentiating benign from malignant solid breast lesions. Patients and methods 56 female patients were included in our study. All patients referred to MRI unit-Radiology Department - Ain Shams University Hospitals to do bilateral breast MRI using conventional sequences, DWI, ADC calculation and post-contrast dynamic study with time/intensity curve using Philips superconductive magnet at 1.5 T with breast surface coil. All the patients were subjected to clinical examination, sonomammography as well as written consent. Also, the histopathological results were recorded. Results 56 lesions were detected, 30 were benign lesions while the rest 26 were malignant lesions. The sensitivity of the DWI was 100% while the specificity was 80%. The ADC values for the benign lesions were 1.1-2.2 × 10-3 mm2/sec, while the malignant lesions showed ADC values of 0.46-0.99 × 10-3 mm2/sec. The ADC value of 1.1 × 10-3 mm2/sec can be used as the cutoff value in differentiating the benign from the malignant lesions. Conclusion DWI and ADC calculation are short unenhanced sequence that can be inserted easily into MRI protocols to accurately differentiate between the benign and malignant breast lesions.