Predictive value of ADC mapping in discriminating probably benign and suspicious breast lesions

Abstract

PurposeThe purpose of this study was to evaluate the usefulness of apparent diffusion coefficient (ADC value) in differentiating between probably benign breast lesions and, suspicious lesions (ACR-BIRADS categories 3 and 4 respectively). Patients and methodsBreast lesions meeting study criteria were identified on dynamic contrast enhanced (DCE)-MRI examinations in 48 women over the course of the study period for 2years. We found 27 (56.2%) of the cases probably benign as their BIRADS category 3 and the remaining 21 (43.7%) cases were category 4. Images were obtained with diffusion sensitizing gradients of 0 and 750mm2/s. The apparent diffusion coefficient (ADC) was calculated and correlated with the histological data. ResultsThe ADC values recorded a sensitivity of 97.9% and a specificity of 80%. The positive predictive value was 95.7% in differentiation between the benign and suspicious breast lesions. The difference in mean ADC for benign breast lesions (BIRADS-3, 1.45±0.46×10−3mm2/s), and suspicious lesions (BIRADS-4, 1.06±0.56×10−3mm2/s) was statistically significant. ConclusionIncluding the ADC diffusion coefficient in the diagnostic work up of patients with indeterminate breast lesions can help in the differentiation between benign and malignant breast lesions.