Quantitative apparent diffusion coefficient metrics for MRI-only suspicious breast lesions: any added clinical value?

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Suspicious breast lesions detected exclusively by MRI (MRI-only lesions) present diagnostic challenges due to their small size and poor characterization.
• Evaluating these MRI-only lesions requires advanced imaging techniques for accurate diagnosis and management.

Purpose of the Study:

• To investigate the clinical significance of quantitative apparent diffusion coefficient (ADC) metrics from diffusion-weighted imaging (DWI).
• To evaluate the diagnostic performance of ADC metrics in differentiating benign from malignant MRI-only breast lesions.

Main Methods:

• 90 suspicious MRI-only lesions (51 malignant, 39 benign) were analyzed.
• Morphological and kinetic BI-RADS parameters and ADC metrics (ADCmin, ADCmax, ADCmean, ADCheterogeneity) were calculated.
• Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.

Main Results:

• Quantitative ADC metrics demonstrated superior diagnostic performance compared to BI-RADS parameters.
• Mean ADC (ADCmean) showed the highest diagnostic performance (AUC=0.825 for masses, 0.812 for non-masses).
• ADCmean and ADCmax were valuable for MRI-only masses, while size, distribution, ADCmin, and ADCmean were significant for non-mass lesions.

Conclusions:

• Quantitative ADC metrics are valuable for differentiating MRI-only breast lesions.
• Mean ADC (ADCmean) is the optimal parameter for distinguishing benign from malignant MRI-only lesions.