Differentiation of clinically benign and malignant breast lesions using diffusion‐weighted imaging

Abstract

Purpose:To evaluate the value of diffusion-weighted imaging (DWI) in distinguishing between benign and malignant breast lesions. Materials and Methods:Fifty-two female subjects (mean age ϭ 58 years, age range ϭ 25-75 years) with histopathologically proven breast lesions underwent DWI of the breasts with a single-shot echo-planar imaging (EPI) sequence using large b values. The computed mean apparent diffusion coefficients (ADCs) of the breast lesions and cell density were then correlated. Results:The ADCs varied substantially between benign breast lesions ((1.57 Ϯ 0.23) ϫ 10 -3 mm 2 /second) and malignant breast lesions ((0.97 Ϯ 0.20) ϫ 10 -3 mm 2 /second). In addition, the mean ADCs of the breast lesions correlated well with tumor cellularity (P Ͻ 0.01, r ϭ -0.542). Conclusion:The ADC would be an effective parameter in distinguishing between malignant and benign breast lesions. Further, tumor cellularity has a significant influence on the ADCs obtained in both benign and malignant breast tumors.

Quantitative diffusion weighted imaging for differentiation of benign and malignant breast lesions: The influence of the choice of b‐values

“…Many studies report absolute threshold ADC values to differentiate benign and malignant lesions (6,7,(11)(12)(13)(14). However, all authors recommended other threshold ADC values, ranging from 1.10Á10 À3 to 1.60Á10 À3 mm 2 /s.…”

“…Many different strategies have been proposed to increase the specificity such as calculating pharmacokinetic contrast parameters (4), T2*-weighted perfusion imaging (5) and MR spectroscopy (5). A promising adjunct MRI technique is diffusion-weighted imaging (DWI) (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). In DCE Breast MRI, lesions are characterized based on morphology, internal enhancement, and kinetic enhancement pattern (16,17).…”

“…Reported absolute ADC threshold values range from 1.10Á10 À3 to 1.60Á10 À3 mm 2 /s (6,7,(11)(12)(13). This variability can be attributed to several factors, including variation in physiological characteristics of the lesions, the use of different scan techniques, and variation in image analysis for ADC calculation.…”

Enhanced mass on contrast‐enhanced breast MR imaging: Lesion characterization using combination of dynamic contrast‐enhanced and diffusion‐weighted MR images

“…Concerning MR protocols other than DCE-MRI, diffusion-weighted MR imaging (DWI) and MR spectroscopy (MRS) have recently been reported to demonstrate usefulness in differentiating benign from malignant breast lesions (11)(12)(13)(14)(15)(16)(17)(18). Since the report by Kinoshita et al (11) in 2002, recent studies using DWI have shown that apparent diffusion coefficient (ADC) values can be useful in differentiating between benign and malignant breast lesions (11)(12)(13)(14)(15).…”

“…Since the report by Kinoshita et al (11) in 2002, recent studies using DWI have shown that apparent diffusion coefficient (ADC) values can be useful in differentiating between benign and malignant breast lesions (11)(12)(13)(14)(15). Diffusion-weighted MRI is a specific modality that produces in vivo images of biological tissues weighted with the local microstructural characteristics of water diffusion.…”