Minjae Yoon, Presenter: Nothing to Disclose

Cheol Mog Hwang MD, Abstract Co-Author: Nothing to Disclose

Keum Won Kim MD, Abstract Co-Author: Nothing to Disclose

Seong Joo Lim, Abstract Co-Author: Nothing to Disclose

Dae Ho Kim, Abstract Co-Author: Nothing to Disclose

Young Jun Cho MD, Abstract Co-Author: Nothing to Disclose

To compare the accuracy of DWI with consideration of ADC with that of dynamic enhanced MRI for the characterization of breast lesions

47 breast lesions of 20 patients (age range, 31-65 years; mean age, 48 years), who underwent subsequent biopsy or operation, were studied prospectively. Dynamic enhanced MRI for these 47 breast lesions were performed, using b values of 1000 s/mm2 on DWI. In order to compare the malignant and benign lesions on DWI, ADCs were measured. Accuracy of characterization was calculated for the dynamic MRI set and the DWI set. These were sorted according to the confidence levels for lesion characterization into five grades. The ROC curve (Az) was calculated for each imaging set.

27 were benign and 33 were malignant lesions (7 DCIS, 1 LCIS and 25 IDC). On enhanced MRI, benign lesion were dominant among BIRADS category 2,3 group, malignant lesion among BIRADS category 4.5 group. sensitivity, speicificity, PPV are 94,52,71%. On DWI set , benign lesion were dominant among confidence level 1,2 group, malignant lesion were dominant confidence level 3,4 and 5. sensitivity, speicificity, PPV are 94,78,84%. Specificity and PPV on DWI was significant higher than enhanced MRI (p<0.05). The characterization accuracy on the DWI set (Az = 0.943) was higher than that on the dynamic enhanced image set (Az = 0.837) for the breast lesions (p < 0.05). The mean ADCs of the IDC (0.94 ± 0.20 x 10-3 mm2/s) and DCIS/LCIS (1.04 ± 0.26 x 10-3 mm2/s) were significantly lower than those of the benign lesions (1.402 ± 0.20 x 10-3 mm2/s). An ADC threshold level of 1.275 x 10-3 mm2/s allowed discrimination between malignant and benign lesions (sensitivity: 83.3%, specificity: 86.4%).

ADC determination and DWI at 3.0 T provided a higher accuracy for differentiation of benign and malignant breast lesions than dynamic enhanced image set. Combined reading of DWI and DCE-MRI has the potential to improve the diagnostic accuracy of breast lesions.

Combined reading of DWI and DCE-MRI has the potential to improve the diagnostic accuracy of breast lesions.

Yoon, M, Hwang, C, Kim, K, Lim, S, Kim, D, Cho, Y, Characterization of Breast Lesions: Diffusion-weighted (DW) Imaging with Consideration of Apparent Diffusion Coefficient (ADC) vs Dynamic-enhanced 3.0 T MR Imaging.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11014899.html