The Value of Combination of Diffusion-Weighted Sequences and Dynamic Contrast MRI Study in Differentiation between Benign and Malignant Breast Lesions

Sarah Ghaleb  Shati

Sarah Ghaleb Shati Lecturer, M.B.Ch.B., C.A.B.M.S., Diagnostic Radiology, Ministry of Higher Education and Scientific Research, Department of Surgery, College of Medicine, University of Thi-Qar, Thi-Qar, Iraq

Keywords: DCE, DWI, MRI, ADC, Breast, Benign breast lesion, Malignant breast lesion

Abstract

MRI, as defined, is a diagnostic imaging technique that employs the use of magnets and high-powered radio waves to analyses the internal structures of the body. The evaluation of breast tumours and the description of lesions that are not adequately observed by mammography or ultrasound. The objective of this study was to evaluate the diagnostic accuracy of DW-MRI and ADC value in differentiating between benign and malignant breast lesions when combined with dynamic contrast-enhanced MRI. A prospective analytic study was conducted on a cohort of women attending the MRI unit of the Radiology Department at Al-Imamein Al-Kadhimein Medical City in Baghdad between April 2018 and February 2019. All women were enrolled in the study prior to undergoing a biopsy, during which dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) were performed. The image fusion of DCE-MRI with the apparent diffusion coefficient (ADC) map was employed to identify the region of interest (ROI) for ADC calculation in the area that demonstrated the most avid enhancement. DWI was acquired at the following b-values (0, 400, 800 sec/mm²). The mean age of the 38 patients was (39.83 ± 10.476) years, with a range of (16-62 years). Of the 46 lesions, 20 (43.5%) were identified as malignant, while 26 (56.5%) were classified as benign. The mean ADC value of all benign lesions was 1.585 ± 0.182 x 10⁻³ mm²/s, which was higher than the mean ADC of all malignant lesions (1.149 ± 0.214 x 10⁻³ mm²/s) (P < 0.0001). Furthermore, a notable distinction was observed between mass and non-mass-enhanced lesions in terms of mean ADC values. The mean ADC value for benign mass lesions was found to be (1.538 ±0.147 x10-3 mm²/s), while the mean ADC value for benign non-mass enhanced lesions was (1.785 ±0.087 x10-3 mm²/s). This difference was statistically significant (P-value 0.004).

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