Assessment of Breast Lesions With Diffusion-Weighted MRI: Comparing the Use of Different b Values

• Published in: American journal of roentgenology (1976) Vol. 193; no. 4; pp. 1030 - 1035
• Main Authors: Pereira, Fernanda Philadelpho Arantes, Martins, Gabriela, Figueiredo, Eduardo, Domingues, Marisa Nassar Aidar, Domingues, Romeu Cortes, da Fonseca, Lea Mirian Barbosa, Gasparetto, Emerson Leandro
• Format: Journal Article
• Language: English
• Published: Reston, VA Am Roentgen Ray Soc 01.10.2009; American Roentgen Ray Society
• Subjects: Adult; Aged; Aged, 80 and over; Algorithms; Biological and medical sciences; Breast Neoplasms - diagnosis; Diffusion Magnetic Resonance Imaging - methods; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Middle Aged; Reproducibility of Results; Sensitivity and Specificity; Young Adult; Nuclear medicine; Radiology; Breast; Medical imagery; Mammary gland; Lesion; Nuclear magnetic resonance imaging; Comparative study
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/AJR.09.2522

Our purpose was to study the utility of diffusion-weighted MRI in differentiating benign from malignant breast lesions by assessing the best b values. Forty-five women (mean age, 46.1 years) with 52 focal mass breast lesions underwent diffusion-weighted imaging with different b values. The apparent diffusion coefficient (ADC) value of each lesion was calculated from the ADC maps done using five b values (0, 250, 500, 750, and 1,000 s/mm(2)) and using b values of 0 s/mm(2) with each other b value separately (0 and 250 s/mm(2), 0 and 500 s/mm(2), 0 and 750 s/mm(2), 0 and 1,000 s/mm(2)). The mean ADC values were correlated with imaging findings and histopathologic diagnoses. The cutoff ADC value, sensitivity, and specificity of diffusion-weighted imaging to differentiate benign and malignant lesions were calculated in all b value combinations. A p value of < 0.05 was considered statistically significant. The mean ADC value was significantly lower for malignant lesions compared to benign lesions (p < 0.0001) in all b value combinations. No statistical difference was seen between the ADC obtained from different b value combinations (p = 0.2581) in the differentiation between benign and malignant lesions. The ADC calculated from b 0 and 750 s/mm(2) was slightly better than the other b value combinations, showing a sensitivity of 92.3% and a specificity of 96.2%. Diffusion-weighted imaging is a potential resource as a coadjutant of MRI in the differentiation between benign and malignant lesions. Such imaging can be performed without a significant increase in examination time, especially because it can be done with lower b values.