Differential diagnosis of benign and malignant breast masses using diffusion-weighted magnetic resonance imaging

World Journal of Surgical Oncology

Jun Yang¹  Lixin Yuan¹  Caisong Zhu¹  Wei Liu¹  Lulan Zhai¹  Kangwei Shao¹  Qinghua Min¹ 

[1] Department of Radiology, Shanghai Tongren Hospital, No. 1111 Xianxia Road, Changning District, Shanghai 200336, PR China

关键词: magnetic resonance imaging;    diffusion-weighted imaging;    differential diagnosis;    b value;    breast lesions;   

Others  :  1131510
DOI  :  10.1186/s12957-014-0431-3

 received in 2014-10-23, accepted in 2014-12-24,  发布年份 2015

【 摘 要 】

Background

Diffusion-weighted magnetic resonance imaging (DW-MRI) is different from conventional diagnostic methods and has the potential to delineate the microscopic anatomy of a target tissue or organ. The purpose of our study was to evaluate the value of DW-MRI in the diagnosis of benign and malignant breast masses, which would help the clinical surgeon to decide the scope and pattern of operation.

Methods

A total of 52 female patients with palpable solid breast masses received breast MRI scans using routine sequences, dynamic contrast-enhanced imaging, and diffusion-weighted echo-planar imaging at b values of 400, 600, and 800 s/mm², respectively. Two regions of interest (ROIs) were plotted, with a smaller ROI for the highest signal and a larger ROI for the overall lesion. Apparent diffusion coefficient (ADC) values were calculated at three different b values for all detectable lesions and from two different ROIs. The sensitivity, specificity, positive predictive value, and positive likelihood ratio of DW-MRI were determined for comparison with histological results.

Results

A total of 49 (49/52, 94.2%) lesions were detected using DW-MRI, including 20 benign lesions (two lesions detected in the same patient) and 29 malignant lesions. Benign lesion had a higher mean ADC value than their malignant counterparts, regardless of b value. According to the receiver operating characteristic (ROC) curve, the smaller-range ROI was more effective in differentiation between benign and malignant lesions. The area under the ROC curve was the largest at a b value of 800 s/mm². With a threshold ADC value at 1.23 × 10⁻³ mm²/s, DW-MRI achieved a sensitivity of 82.8%, specificity of 90.0%, positive predictive value of 92.3%, and positive likelihood ratio of 8.3 for differentiating benign and malignant lesions.

Conclusions

DW-MRI is an accurate diagnostic tool for differentiation between benign and malignant breast lesions, with an optimal b value of 800 s/mm². A smaller-range ROI focusing on the highest signal has a better differential value.

【 授权许可】

   
2015 Min et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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