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

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 x 10(-3) mm(2)/s. and the benign lesions showed a mean ADC value of 1.54 +/- 0.43 x 10(-3) mm(2)/S. The receiver operating characteristic (ROC) curve could identify an ADC 1.26 x 10(-3) mm(2)/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.