Application of Diffusion Weighted Imaging Techniques for Differentiating Benign and Malignant Breast Lesions

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Differentiating benign and malignant breast lesions is crucial for appropriate patient management.
• Diffusion weighted magnetic resonance imaging (DW-MRI) offers insights into tissue microstructures.

Purpose of the Study:

• To evaluate the diagnostic value of apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), and diffusional kurtosis imaging (DKI) parameters in distinguishing benign from malignant breast lesions.
• To compare the efficacy of single and combined DW-MRI parameters for breast lesion characterization.

Main Methods:

• Prospective collection of DW-MRI data from 215 patients with breast lesions.
• Application of single exponential, IVIM, and DKI models to calculate parameters like ADC, perfusion fraction (f), D, D*, mean kurtosis (MK), and mean diffusivity (MD).
• Analysis of parameter differences between lesion types using ROC curves to determine diagnostic thresholds and efficacy.

Main Results:

• Significant differences in ADC, D, MK, and MD values were observed between benign and malignant breast lesions (P<0.001).
• Single-parameter ADC demonstrated the highest diagnostic efficiency (AUC 0.915), with sensitivity 91.45% and specificity 82.54%.
• Combination of ADC and MK showed comparable diagnostic performance (AUC 0.923) to ADC alone, without statistically significant improvement (P=0.268).

Conclusions:

• ADC, D, MK, and MD parameters are valuable for differentiating benign and malignant breast lesions.
• ADC alone provides excellent diagnostic performance for breast lesion characterization.
• Combining ADC with MK may offer a marginal enhancement in diagnostic accuracy.