Diffusion-weighted MR imaging: Role in the differential diagnosis of breast lesions

Abstract

Purpose: To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) values to the characterization of breast lesions and differentiation of benign and malignant lesions. Materials and methods: Thirty-seven women (mean age, 38 years) with 37 enrolled in the study. DWI and ADC maps in the axial plane were obtained using a 1.5 Tesla MRI device. Mean ADC measurements were calculated among cysts, normal fibroglandular tissue, benign lesions and malignant lesions were evaluated. Results: Out of 37 women, 4 had normally breast MRI findings. The diagnosis of remaining 33 patients with 37 breast lesions were as follows; malign lesions (n = 23), benign lesions (n = 10) and simple breast cyst (n = 4). The ADC values were as follows ( in units of 10-3 mm2/s ): Normal fibroglandular tissue (range: 1.39-2.06; mean:1.61 ± 0.23), benign breast lesions (range: 1.09-1.76; mean: 1,47 ± 0.25), cyts (range: 2.27-2.46, mean: 2,37 ± 0.07) and malignant breast lesions (range: 0.78-1.26, mean: 0.96 ± 0.25). The mean ADC obtained from malignant breast lesions was statistically different from that observed in benign solid lesions (p < < 0.01) and normal fibroglandular breast tissue (p < 0.01). Furthermore, the mean ADC values of benign breast lesions was not statistically different from cyst (p ≥ 0,01) and normal fibroglandular breast tissue (p ≥ 0,01). A ADC value of 1.1 × 10-3 mm2/s as a treshold value provided differantiation for malign and benign lesions, with a sensitivity of 91.3% and a specificity of 85.7% compared with conventional breast MRI values. Conclusion: DWI with quantitative ADC measurements is a reliable tool for differentiation of benign and malignant breast lesions.