Optimization of apparent diffusion coefficient measured by diffusion-weighted MRI for diagnosis of breast lesions...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Magnetic resonance imaging (MRI) is crucial for breast lesion characterization.
• Diffusion-weighted imaging (DWI) provides insights into tissue microstructure.
• Apparent diffusion coefficient (ADC) values quantify water molecule diffusion, aiding in lesion differentiation.

Purpose of the Study:

• To evaluate the diagnostic performance of ADC values in differentiating benign from malignant breast lesions.
• To compare ADC values between mass-like enhancement and non-mass-like enhancement (NMLE) lesions.
• To determine the utility of ADC in diagnosing invasive cancer, ductal carcinoma in situ (DCIS), and benign conditions.

Main Methods:

• Retrospective analysis of 174 patients with 188 histologically confirmed breast lesions.
• ADC values measured using spin-echo echo-planner-imaging (SE-EPI) sequence with b=1,000 s/mm(2).
• Receiver operating characteristic (ROC) analysis performed to assess diagnostic accuracy.

Main Results:

• Mean ADC values differed significantly across lesion types: invasive cancer (0.99 × 10(-3)mm(2)/s), DCIS (1.23 × 10(-3)mm(2)/s), and benign adenosis (1.52 × 10(-3)mm(2)/s).
• NMLE lesions exhibited higher mean ADC (1.44 × 10(-3)mm(2)/s) compared to mass lesions (1.12 × 10(-3)mm(2)/s).
• Optimal ADC cutoffs for differentiation were 1.05 × 10(-3)mm(2)/s for mass lesions and 1.35 × 10(-3)mm(2)/s for NMLE lesions.

Conclusions:

• ADC values are valuable for diagnosing malignant and benign breast lesions, including invasive cancer, DCIS, and adenosis.
• The distinction between mass and NMLE lesion morphology is important when interpreting ADC values.
• Integrating ADC measurements with lesion morphology enhances diagnostic accuracy in breast MRI.