Effectivity of combined diffusion-weighted imaging and contrast-enhanced MRI in malignant and benign breast lesions
More details
Hide details
Publication date: 2018-02-15
Pol J Radiol, 2018; 83: 82-93
Mammography is the most commonly used diagnostic test for breast lesion detection and evaluation, but in dense breast parenchyma it lowers its sensitivity to detect small lesions. Sensitivity and specificity improves with combined use of contrast-enhanced magnetic resonance imaging (CE-MRI) and diffusion-weighted imaging (DWI) in differentiating benign and malignant breast lesions. The aim of the study was to evaluate the effectivity of combined dynamic CE-MRI and DWI in differentiating benign and malignant lesions, and to calculate the apparent diffusion coefficient (ADC) values of malignant and benign lesions of the breast.

Material and methods:
Fifty-seven patients with 68 lesions were included in the study. MRI of breast using different sequences was acquired on 1.5 Tesla Machine with dedicated breast coils. Dynamic CE-MRI along with DWI was acquired for each patient. Histopathological reports were accepted as the standard of reference.

Out of 68 lesions, 37 were malignant on biopsy (54.4%) and 31 were benign (45.5%). The sensitivity of CE-MRI was 92%, specificity 84.21%, positive predictive values (PPV) 88.46 %, and negative predictive values (NPP) 88.89%. The sensitivity of DWI-MRI was 91.6%, specificity was 90.6%, PPV 91.6%, and NPP 90.6%. The sensitivity of combined DWI-MRI and CE-MRI was 95.0%, specificity was 96.43%, PPV 97.44%, and NPP 93.10%. Mean ADCs of benign lesions (b = 800) was 1.905 ± 0.59 × 10–3 mm (2)/s, which was significantly higher than those of malignant lesions (b = 800) 1.014 ± 0.47 × 10–3 mm (2)/s.

Multi-parametric MRI is an excellent non-invasive modality with high sensitivity and specificity to differen­tiate malignant from benign breast lesions.

Catalano O, Nunziata A, Siani A. The breast, in fundamentals in oncologic ultrasound. Sonographic imaging and intervention. Springer- Verlag, Milan 2009; 145-117.
Cancer Stat Facts: Female Breast Cancer; https://seer.cancer.gov/statfa....
Over 17 lakh new cancer cases in India by 2020; ICMR http://icmr.nic.in/icmrsql/arc....
Kul S, Cansu A, Alhan E, et al. Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of breast tumors. Am J Roentgenol 2011; 196: 210-217.
Hetta W. Role of diffusion weighted images combined with breast MRI in improving the detection and differentiation of breast lesions. Egypt J Radiol Nucl Med 2015; 46: 259-270.
Tillman GF, Orel SG, Schnall MD, et al. Effect of breast magnetic resonance imaging on the clinical managment of women with early- stage breast carcinoma. J Clin Oncol 2002; 20: 3413-3423.
Li CI, Uribe DJ, Daling JR. Clinical characteristics of different histological types of breast cancer. Br J Cancer 2005; 93: 1046-1052.
Mahoney CM. Breast imaging: mammography, sonography and emerging technology. In: Cancer of the Breast. Donegan LW,.
Spratt SJ (eds.). Elsevier Science, Philadelphia 2002.
Darbre DPH. Recorded quadrant incidence of female breast cancer in Great Britain suggests a disproportionate increase in the upper outer quadrant of the breast. Anticancer Res 2005; 25: 2543-2550.
Wedegärtner U, Bick U, Wörtler K, et al. Differentiation between benign and malignant findings on MR-mammography: usefulness of morphological criteria. Eur Radiol 2001; 11: 1645-1650.
Tozaki M, Igarashi T, Fukuda K. Positive and negative predictive values of BI-RADS descriptors for focal breast masses. Magn Reson Med Sci 2006; 5: 7-15.
Chakraborti KL, Bahl P, Sahoo M, et al. Magentic resonance imaging of breast masses: comparison with mammography. Indian J Radiol Imaging 2005; 15: 381-387.
Park MJ, Cha ES, Kang BJ, et al. The role of diffusion-weighted imaging and the apparent diffusion coefficient (ADC) values for breast tumors. Korean J Radiol 2007; 8: 390-396.
El Bakry MAH, Sultan AA, El-Tokhy NAE, et al. Role of diffusion weighted imaging and dynamic contrast enhanced magnetic resonance imaging in breast tumors. Egypt J Radiol Nucl Med 2015; 46: 791-804.
Journals System - logo
Scroll to top