Role of Diffusion-Weighted Imaging in Assessment of Breast Lesions
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- Category: Vol. 81, June 2013
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Role of Diffusion-Weighted Imaging in Assessment of Breast Lesions,WAEL ABD ULGHAFFARA and MAGDY M. TAG-ALDEIN
Abstract
Objective: The aim of our study was to shed light on the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) for assessment of breast lesions.
Material and Methods: 51 patients (age range, 24-66 years; mean age, 48 years) with suspicious clinical findings and positive diagnoses at mammography were included in our study. MM examinations were performed using a 1.5-T MRI scanner (Magnetom Espree, Siemens Healthcare) with a dedicated 4-channel phased array bilateral breast coil. MM study was done using bilateral fat-suppressed T2- weighted fast spin-echo, STIR, axial T1-weighted fast spin-echo. DWI series were acquired using echo planar imaging pulse sequences incorporating with diffusion gradients. Finally, dynamic axial bilateral breast images of fat-suppressed high-resolution T1-weighted 3D fast gradient-echo images were sequentially acquired.
Results: Sixty three lesions were detected in the 51 patients included in our study. Twenty one lesions were malignant, three lesions were intermediate and twenty two lesions were fibroadenoma according to the final histopathological study and seventeen lesions were breast cysts. A total of 21 lesions showed lower ADC values than benign lesions and were in the range of (0.76-1.29 x10-3 mm2/s) and were diagnosed as malignant breast lesions. The sensitivity and specificity for DWI in the differentiating malignant breast lesions from benign breast lesions were calculated and showed 95.4% and 97.5%, respectively.
Conclusion: In conclusion, DWI is easy to obtain in short scan time and easy to evaluate, and ADC values can differen-tiate between benign and malignant breast lesions with high sensitivity & specificity. DWI is problem solving sequence in patients with contraindication to contrast media. We add DWI sequence to the standard MM examination of the breast before contrast study and according to the result of our study it is a promising sequence. However, more studies with larger populations are needed for more evaluation of DWI in breast lesions.