Role of diffusion weighted imaging and dynamic contrast enhanced MR mammography to detect recurrence in breast cancer patients after surgery

To assess role of Diffusion weighted imaging (DWI) in addition to dynamic contrast-enhanced magnetic resonance mammography (DCE-MRM) in detection of breast cancer recurrence after surgery. Patients and methods: Sixty female patients who underwent breast surgery were included in this prospective study. Patients were examined by sonomammography followed by DCE-MRI to exclude recurrence. DWI was performed using b values of 0, 50, and 850 s/mm². Patients with suspected recurrence were subjected to histopathological confirmation. Results: Twenty seven patients had pathologically proven recurrence and thirty three patients showed spectrum of post operative changes. DCE-MRI was superior to DWI with 2 false positive (FP) cases and no false negative (FN) cases, while DWI showed 3 (FN) cases and 4 (FP) cases. DCE-MRI and DWI showed sensitivity (100%, 88.9%), specificity (93.9%, 87.9%), positive predictive value (PPV) (93.1%, 88.9%), negative predictive value (NPV) (100%, 90.6%) and accuracy (96.7%, 88.3%) respectively. Conclusion: Our study showed better diagnostic performance for DCE-MRI compared to DWI in post operative breast assessment. However, DWI can provide an alternative diagnostic tool to contrast administration if interpreted in association with conventional MR sequences thus can be used when contrast media is contraindicated