ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2021
vol. 86
 
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Breast radiology
abstract:
Original paper

Efficacy of high-resolution, 3-D diffusion-weighted imaging in the detection of breast cancer compared to dynamic contrast-enhanced magnetic resonance imaging

Pratiksha Yadav
1
,
Saumya Harit
2
,
Dileep Kumar
3

1.
Dr. D.Y. Patil Medical College, Hospital and Research Centre, DPU, Pune, India
2.
Kasturba Medical College, Manipal University, Manipal, India
3.
MR Research and Collaborations, Siemens Healthcare Private Limited, Bangalore, India
Pol J Radiol 2021; 86: e277-e286
Online publish date: 2021/05/10
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Introduction
To evaluate the utility of high-resolution, 3-D diffusion-weighted imaging (DWI) in the detection of breast cancer and to compare the sensitivity, specificity, and area under the curves of DWI and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Material and methods
Prospective IEC approved study included 131 breast lesions detected on mammography and breast ultrasound. Cases underwent MRI on a 3 Tesla scanner using a dedicated breast coil. T2WI, STIR, T1WI, and dynamic post contrast MR. DWI MRI with b value of 50, 800, and 1500 s/mm2. Post-processing data with apparent diffusion coefficient (ADC) calculations and kinetic curves were obtained. Characteristics for lesions were analysed as per ACR BI-RADS descriptors. Final histopathological diagnosis was considered as the standard of reference. 2 test, t-test, receiver operating characteristic (ROC) curve analysis, pairwise comparison of ROC curves, sensitivity, specificity, diagnostic accuracy, and area under the curve (AUC) were calculated.

Results
Sixty-six (50.38%) malignant and 65 (59.62%) benign lesions were included in the study. The mean ADC of malignant lesions was 0.870 × 10–3 mm2/s and 1.637 × 10–3 mm2/s (p < 0.0001) for benign lesions. Sensitivity and specificity for DWI were 95.45% and 90.76%, respectively, and for DCE-MRI they were 96.97% and 87.69%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) were obtained at 91.30% and 95.16%, respectively, in DWI while in DCE-MRI they were 88.88% and 96.61%, respectively. The AUC for ADC was 0.979. In ROC comparison of AUC for DWI 0.931 and for DCE-MRI 0.923, the difference between the areas was 0.00781 (p = 0.782).

Conclusions
High-resolution DWI is a non-contrast MRI technique, which improves the lesion detection with diagnostic performance comparable to DCE-MRI and has potential as an adjunct with screening mammography.

keywords:

breast cancer, DCE-MRI, breast MRI, diagnostic technique, diffusion weighted, screening




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