ISSN: 1899-0967
Polish Journal of Radiology
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vol. 86
Breast radiology
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
Saumya Harit
Dileep Kumar

Dr. D.Y. Patil Medical College, Hospital and Research Centre, DPU, Pune, India
Kasturba Medical College, Manipal University, Manipal, India
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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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.

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).

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.


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

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