Application study of differentiating malignant benign from breast lesions using multiple b-value DWI

Abstract

Objective: To explore the diagnostic value of multi b-value DWI (MB-DWI) in the identification of benign and malignant breast lesions. Methods: From October 2013 to December 2015, a total of 54 cases from Ningbo Medical Center Lihuili Hospital (22 benign cases with a total of 24 lesions, 32 malignant cases with a total of 38 lesions) were examined with conventional MR scan, single b-value DWI, and multiple b-value DWI (0, 10, 20, 30, 50, 100, 200, 400, 800, 1 200, 2 000, 3 000 s/mm(2)). GE ADW4.5 workstation was used to calculate the value of standard apparent diffusion coefficient (ADC(standard)), slow apparent diffusion coefficient(ADC(slow)), fast apparent diffusion coefficient (ADC(fast)) and fraction of ADC(fast)(f(fast)). Receiver operating characteristic (ROC)curve was performed to evaluate those MB-DWI parameters above. Results: The ADC(standard), ADC(slow) and f(fast) value of malignant group were (0.761±0.166)×10(-3) mm(2)/s, (0.593±0.144)×10(-3) mm(2)/s, 0.330±0.099 respectively, which were significantly lower than those of benign group (all P<0.01), while the ADC(fast) value of malignant group was 4.379×10(-3) mm(2)/s, significantly higher than that of benign group(P<0.01). The area under curve (AUC) of f(fast) and ADC(standard) were 0.799, 0.786 respectively and there is no statistically significant difference.The AUC of ADC(slow), ADC(fast) were 0.719, 0.727, which were statistically significant different from the value of f(fast) or ADC(standard)(all P<0.01). Conclusions: All the parameters in MB-DWI can be used to distinguish benign from malignant breast lesions.The f(fast) and ADC(standard) value have higher diagnostic value in the identification of benign and malignant breast lesions.