Ahmed Abdel Razek, Presenter: Nothing to Disclose

Adel Denewer, Abstract Co-Author: Nothing to Disclose

Ahmed Galal, Abstract Co-Author: Nothing to Disclose

Lamiaa Elserougy, Abstract Co-Author: Nothing to Disclose

Esmail Tawakol, Abstract Co-Author: Nothing to Disclose

Nadia Nada, Abstract Co-Author: Nothing to Disclose

To evaluate the role of diffusion weighted echoplanar MR imaging in characterization of breast lesions.

Prospective study was conducted on 77 consecutive untreated female patients (aged 25-64 ys: mean 45 ys) with breast lesions. All patients were examined at 1.5 Tesla using dedicated bilateral breast coil. They underwent dynamic contrast enhanced MR imaging and diffusion weighted MR imaging of the breast using a single shot echo planar imaging with a b-factor of 0,200 & 400 sec/mm2. The scanning parameters were: TR= 10000 ms, TE=108ms, NEX=2, bandwidth=125 kHz, FOV= 2-25cm, slice thickness =4 mm. Apparent diffusion coefficient (ADC) maps were reconstructed. The ADC value of the breast lesion was calculated and correlated with surgical findings or biopsy.

Adequate ADC maps were obtained in 73 patients. The smallest lesion detected was 0.9mm. The mean ADC value of cancer breast was 1.02±0.13X 10-3 mm2/sec and of benign lesions was 1.47±0.07X 10-3 mm2/sec. There was statistically difference in mean ADC values between malignant breast tumors and benign lesions (p<0.003) and within the malignant tumor (P<0.04). The mean ADC value of invasive ductal carcinoma was lower than that of non invasive ductal carcinoma. The ADC value correlated with tumor cellularity (r=076). When apparent diffusion coefficient value of 1.6 X 10-3 mm2/sec was used as a threshold value for differentiating of malignant tumors from benign lesions, the best result was obtained with an accuracy of 95%, sensitivity 92%, specificity 96%, positive predictive value 92% and negative predictive value of 96%.

Apparent diffusion coefficient value is a new non-invasive imaging parameter that can be used for characterization of breast lesions as it helps in differentiation benign lesions from malignant tumor.

Diffusion weighted MR imaging can be added to routine MR imaging in patients with breast mass as they provide valulabe information for differentiation of the breast masses.

Abdel Razek, A, Denewer, A, Galal, A, Elserougy, L, Tawakol, E, Nada, N, Characterization of Breast Lesions with Diffusion-weighted MR Imaging.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5000243.html