Diffusion weighted (DW) MRI role in characterization of breast lesions using absolute and normalized ADC values

Diffusion weighted imaging (DWI) is a modality that depicts the diffusivity of water molecules.This technique has the potential to play an adjunct role to conventional and dynamic MRI in the assessment of breast tissue. Aim of work: To evaluate the role of DWI with absolute and normalized ADC value measurements in characterization of breast lesions. Patients and methods: Seventy patients with mass or non mass lesions on mammography or breast ultrasound were included in this study. DWI were added to routine MR study with calculation of ADC absolute value and normalized ratio for lesions before biopsy of their breast lesions and results were correlated with histopathology. Results: Thirty out of 70 detected lesions were malignant. Malignant lesions showed lower ADC values and lower ratio of normalized ADC than benign lesions. The ROC study revealed that a cutoff ADC value of 1.1 multiplication sign 10^-3mm²/s and normalized ADC ratio of 0.9 had high sensitivity of 89.75%, and 92.2% with specificity of 94.4% and 94.4% respectively in the differentiation between benign and malignant breast lesions. Conclusion: DWI is a short unenhanced scan that can be potential adjunct to conventional breast MRI and can be used to accurately characterize breast lesions with high sensitivity and specificity Suggested