Diagnostic value of apparent diffusion coefficients to differentiate benign and malignant breast lesions

Abstract

The role of magnetic resonance diffusion-weighted imaging (DWI) to differentiate between malignant and benign lesions in the breast using mean apparent diffusion coefficient (ADC) values was evaluated prospectively in this study. Fifty female patients with 61 histopathologically proven solid breast lesions underwent dynamic contrast-enhanced magnetic resonance imaging and DWI using the spin-echo echo-planar technique. ADC maps have been obtained and ADCs of the lesions were calculated without knowledge of histopathological diagnosis. Golden standard was histology to define benign and malignant lesions. Statistical analysis was used to compare ADC values in the benign and malignant group and to calculate best cut-off value for distinguishing both groups based on receiver operator-curve characteristics (ROC). Differentiation of the benign and the malignant masses revealed that the threshold value of the ADC in maximum sensitivity and specificity was 1.22×10-3 mm2/s; at this threshold sensitivity was 96.2%, its specificity was 88.5%, and its positive predictive value was 86.2%. Its negative predictive value was 96.9%, and the accuracy rate was 91.8%. ROC analysis showed an area under the curve of 0.924 (p<0.001). Breast MRI with DWI using ADC measurements can be useful in the differentiation of benign and malignant breast lesions. J. Exp. Clin. Med., 2013; 30:305-310