Contribution of Diffusion-Weighted Imaging and ADC Values to Papillary Breast Lesions

This study aimed to evaluate the role of apparent diffusion coefficient (ADC) values obtained from diffusion-weighted imaging (DWI) in the differentiation of malignant from benign papillary breast lesions. The magnetic resonance imaging (MRI) data of 94 breast papillary lesions confirmed by pathology were retrospectively analyzed. The differences in ADC values of papillary lesions under different enhancements in MRI and different pathological types were investigated, and the ADC threshold was determined by the receiver operating characteristic curve for its potential diagnostic value. The mean ADC values in borderline and malignant lesions (1.01 ± 0.20 × 10^-3 mm²/s) were significantly lower compared to benign lesions (1.21 ± 0.27 × 10^-3 mm²/s) (P < 0.05). The optimal threshold of the ADC value could be 1.00 × 10^-3 mm²/s. The ADC values were statistically significant in differentiating between benign and malignant papillary lesions whether in mass or non-mass enhancement (P < 0.05). However, there were no statistical differences in the ADC values among borderline or any other histological subtypes of malignant lesions (P > 0.05). Measuring ADC values from DWI can be used to identify benign and malignant breast papillary lesions. The diagnostic performance of the ADC value in identifying benign and malignant breast lesions is not affected by the way of lesion enhancement. However, it shows no use for differential diagnosis among malignant lesion subtypes for now. The ADC value of 1.00 × 10^-3 mm²/s can be used as the most appropriate threshold for distinguishing between benign and malignant breast papillary lesions.