Diffusion weighted imaging in breast MRI: comparison of two different pulse sequences

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Breast MRI is crucial for differentiating benign and malignant lesions.
• Diffusion-weighted imaging (DWI) aids in lesion characterization.
• Comparing DWI sequences is essential for optimizing diagnostic accuracy.

Purpose of the Study:

• To compare the efficacy of two diffusion-weighted (DW) MRI sequences in differentiating benign from malignant breast lesions.
• To evaluate lesion visibility and apparent diffusion coefficient (ADC) values between EPI fs and EPI STIR sequences.

Main Methods:

• Breast MRI was performed on 165 women, with 64 focal lesions meeting inclusion criteria.
• Two DW sequences were used: echo-planar imaging with spectral fat saturation (EPI fs) and DW EPI with inversion recovery (EPI STIR).
• Lesion visibility and ADC values (b-values 50, 400, 800) were analyzed.

Main Results:

• Lesion visibility was significantly better with the EPI fs sequence (P<0.05).
• ADC values for benign lesions (EPI fs): mean 1.76, max 2.58, min 1.21.
• ADC values for malignant lesions (EPI fs): mean 0.90, max 1.19, min 0.34.
• The EPI fs sequence showed no overlap in ADC values between benign and malignant lesions.

Conclusions:

• Both EPI fs and EPI STIR DW MRI sequences show potential for differentiating breast lesions.
• The EPI fs sequence is preferred due to superior lesion visibility and selectivity.
• Optimized DWI sequences enhance the diagnostic performance of breast MRI.