Differentiation between Benign and Malignant Breast Lesions Using ADC on Diffusion-Weighted Imaging at 3.0 T

Aim: To investigate the diagnostic efficiency of apparent diffusion coefficient value (ADC) in differentiating benign from malignant breast lesions at 3.0 T diffusion-weighted imaging with different pair of b value. Methods: Total 110 patients with 107 lesions (44 benign and 63 malignant) were selected for our study with five different b-values 0, 400, 800, 1200 and 1600 s/mm2. ADC values were calculated using different pairs of b values. The cut-off ADC values and diagnostic efficiency were evaluated by receiver operating characteristic analysis. Comparison of Mean ADC value for breast lesions was determined by using independent sample t test. ROC curves were used for diagnostic efficiency of ADC using different pairs of b values. Results: With increase of b value, mean ADC value decreases. The mean ADC values for benign were 1.73 × 10−3 mm2/s for b 0 and 400, 1.57 × 10−3 mm2/s for b 0 and 800, 1.43 × 10−3 mm2/s for b 0 and 1200 and 1.30 × 10−3 mm2/s for b 0 and 1600 s/mm2. The mean ADC values for the malignant breast lesion were 1.21 × 10−3 mm2/s for b 0 and 400, 1.06 × 10−3 mm2/s for b 0 and 800, 0.94 × 10−3 mm2/s for b 0 and 1200 and 0.86 × 10−3 mm2/s for b 0 and 1600 s/mm2. ADC diagnostic efficiency for benign and malignant lesion for all the pair of b value combination was significant (p > 0.05). The sensitivity, specificity, PPV, NPV and accuracy were 80.95%, 90.9%, 92.72%, 76.92%, 85.04% for b 0 and 400; 84.12%, 90.9%, 92.98%, 80%, 86.91% for b 0 and 800; 84.12%, 90.9%, 92.98%, 80%, 86.91% for b 0 and 1200; 84.12%, 90.9%, 92.98%, 80%, 86.91% for b 0 and 1600 s/mm2 respectively. Conclusion: DWI is effective in differentiating benign and malignant breast lesion at 3.0 Tesla using ADC with higher b value combination.