Role of Multiparametric MRI in Characterization of Breast Lesions- A Cross-Sectional Study

Conventional MRI demonstrated high sensitivity but limited specificity. In contrast, the addition of multiparametric MRI (mpMRI) sequences improved diagnostic accuracy in differentiating malignant from benign lesions. Given the paucity of such studies in the Indian population, we evaluated the role of mpMRI using a 3 T MRI scanner in correlation with histopathological findings. A total of 28 participants underwent mpMRI including diffusion weighted imaging (DWI), dynamic contrast enhanced MRI (DCE-MRI) and single voxel MR Spectroscopy (SV-MRS). In comparison with histopathological findings, imaging data were analysed to differentiate benign from malignant lesions using appropriate statistical tools. Malignant lesions were predominantly irregular in shape, spiculated in margins, and showed heterogeneous enhancement with a type II curve on DCE-MRI. They demonstrated lower apparent diffusion coefficient values and the presence of a total choline peak at 3.2 ppm on SV-MRS in the majority of cases, which was statistically significant. Sequential integration of mpMRI enhanced specificity to 87.5%, while the combination of T2-weighted, DCE-MRI, and DWI provided the most balanced diagnostic performance. In our opinion, mpMRI can improve diagnostic accuracy, aiding in early diagnosis and management while minimizing the need for interventions such as biopsy. Additionally, non-contrast combinations, such as T2-weighted imaging, DWI, and SV-MRS, improved specificity but require further refinement to enhance its sensitivity.

The online version contains supplementary material available at 10.1007/s13193-025-02440-3.