Abstract
Magnetic resonance imaging (MRI) of the breast has been increasingly used for the detailed evaluation of breast lesions. Diffusion-weighted imaging (DWI) gives additional information for the lesions based on tissue cellularity. The aim of our study was to evaluate the possibilities of DWI, apparent diffusion coefficient (ADC) value and ADC ratio (the ratio between the ADC of the lesion and the ADC of normal glandular tissue) to differentiate benign from malignant breast lesions. Materials and methods: Eighty-seven patients with solid breast lesions (52 malignant and 35 benign) were examined on a 1.5 T MR scanner before histopathological evaluation. ADC values and ADC ratios were calculated. Results: The ADC values in the group with malignant tumors were significantly lower (mean 0.88 ± 0.15 × 10−3 mm2/s) in comparison with the group with benign lesions (mean 1.52 ± 0.23 × 10−3 mm2/s). A significantly lower ADC ratio was observed in the patients with malignant tumors (mean 0.66 ± 0.13) versus the patients with benign lesions (mean 1.12 ± 0.23). The cut-off point of the ADC value for differentiating malignant from benign breast tumors was 1.11 × 10−3 mm2/s with a sensitivity of 94.23%, specificity of 94.29%, and diagnostic accuracy of 98%, and an ADC ratio of ≤0.87 with a sensitivity of 94.23%, specificity of 91.43%, and a diagnostic accuracy of 95%. Conclusion: According to the results from our study DWI, ADC values and ADC ratio proved to be valuable additional techniques with high sensitivity and specificity for distinguishing benign from malignant breast lesions.
Highlights
Breast soft tissue lesions often represent a diagnostic challenge in daily practice.Covering a wide spectrum of histological conditions, they are broadly subdivided into malignant and benign tumor lesions
Based on the existing discrepancies, in our study, we aimed to evaluate the role of Diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) value and ADC ratio in the differentiation of benign from malignant breast lesions in patients with proven histopathological diagnoses
We believe that our study presents valuable data about ADC values, ADC ratios, and their potential for differentiating benign from malignant breast lesions—and adds to the existing knowledge
Summary
Breast soft tissue lesions often represent a diagnostic challenge in daily practice.Covering a wide spectrum of histological conditions, they are broadly subdivided into malignant and benign tumor lesions. On the other hand, following histological examination, lesions in the breast are frequently confirmed to be benign in origin, so unnecessary biopsies are often reported [3,4]. In this aspect, applying a non-invasive imaging technique with a high diagnostic potential is of great importance to avoid unnecessary interventional procedures and reduce costs, solving the dilemma of whether it is a malignant or non-malignant lesion [5,6,7]. Magnetic resonance imaging (MRI) of the breast has been used increasingly during the last decade as a preferred problem-solving method in complicated and unclear cases such as in women with “dense breast”, multiple lesions, the evaluation of residual tumor, recurrence or granulation tissue after intervention [8,9,10], due to its ability to reveal both the morphologic structure and the kinetic properties of the pathologic lesion [8,11]
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