Role of Diffusion Weighted Magnetic Resonance Imaging in Evaluation of Suspicious Breast Lesions

Abstract

Introduction: Diffusion weighted Imaging“DWI”is a specific modality to produce images of tissues weighted with the local microstructural characteristics of water diffusion. DWI can give information as regards cellularity of breast lesions and it can be used for distinguishing between benign and malignant breast lesions, differentiating surgical scar from recurrence and monitoring therapies in locally advanced breast cancer Aim of the work: To assess the diagnostic value of diffusion weighted imaging as an adjuvant to breast magnetic resonance imaging for detection and differentiation of suspicious breast lesions and correlation with histopathologic findings, available clinical data or follow up. Methods: The studied group included 50 female patients referred for MRI breast for workup of a suspicious clinical, mammographic, or sonographic abnormality. Diffusion weighted imaging (DWI) was added to the routine study. Results of the contrast enhanced bilateral breast MRI and DWI of the 50 patients were all reported and compared with the histo-pathological results of surgery or biopsy and with the results of follow up of lesions that were not surgically removed or biopsied. Results: there was a highly significant relation between DWI and histopathological/ Follow Up results with p value = 0.000. The sensitivity, specificity, positive and negative predictive values of DWI for characterization of suspicious breast lesions in patients included in the study, were 89.5%, 100%, 100%, and 93.94% respectively. Conclusion: DWI is a short unenhanced scan that can be inserted easily into standard clinical breast MRI protocols as a potential adjunct that can be added routinely to conventional breast MRI, and can accurately differentiate benign from malignant breast lesions with high sensitivity and specificity.