ROLE OF DIFFUSION WEIGHTED MRI IN EVALUATION OF BIRADS3 AND BIRADS4 BREAST LESIONS

Background: Precise diagnosis of suspicious breast lesions helps in better assessment and management. The aim of this study is to explore the role of DCE-MRI and DWI in evaluation of suspicious breast lesions (BI-RADS 3 and 4). Subjects and Methods: A total of 50 patients with suspicious breast lesions (BI-RADS 3 and 4) participated in the study. After giving informed consent, all patients were subjected to DWI and DCE-MRI, and their findings were compared to histopathology results. DCE-MRI curves, borders, and enhancement were described, and DWI findings were also extracted. Factors predicting distinction of cancerous tissue from benign tissue by DCE-MRI and DWI according to histopathology reference have been analyzed. Results:Using DCE-MRI, out of 19 patients proven by histopathology to have benign lesions, 12 (63.2%) showed mass lesions and out of 29 patients with malignant lesions 21 (72.4%) had mass lesions (p<0.001).Curves of benign lesions were mostly persistent (83.3%) whenever malignant curves were either plateau or wash out;(47.6%) each (p<0.001).ADC brightness was more frequent in benign lesions (p<0.05). The best cut-off of ADC that can differentiate between malignant and benign lesions was 1.19 (sensitivity 94.7% and specificity 67.7%).DCE-MRI had a sensitivity of 75.8% and specificity of 73.7%, while DWI had a sensitivity of 82.8% and specificity of 73.7%. No statistically significant differences have been noticed between benign and malignant breast non-mass lesions regarding any of the studied measures (p>0.05). Conclusion: DCE-MRI and DWI are crucial in distinction of suspicious breast mass lesions. The sensitivity and specificity of DCE-MRI and DWI as diagnostics have been determined.