Evaluate the ADC Values in Probably Benign and Suspicious Malignant Breast Lesions

Abstract

Background: Breast carcinoma is at increasing trend in India. The young age has been found to be a major risk factor for breast carcinoma in Indian females. The age adjusted rate of carcinoma breast is found as high as 41/100,000 in different registries. The conventional imaging for breast have their own limitations. MRI is a promising tool. The diffusion weighted imaging (DWI) is influenced by histologic structure and is an indirect evidence of histology. Aim: To characterize probably benign and suspicious breast lesions with non invasive MRI techniques of diffusion weighted imaging (DWI) using apparent diffusion coefficient (ADC) values and to correlate the values of apparent diffusion coefficient (ADC) with histopathological findings of breast lesions. Study Design: Observational study. Place and Duration of Study: The study was conducted in Department of Radiology of Himalayan Institute of Medical Sciences, SRH University, Dehradun from September 2016 to June 2018. Methods: In this observational study, 54 patients were included with diagnosis of BIRADS III and BIRADS IV on X ray mammography and sonomammography. The diffusion weighted imaging (DWI) MRI was done and apparent diffusion coefficient (ADC) values were calculated and results were correlated with histopathological outcome. Results: Comparison between the diffusion weighted imaging (DWI) analysis and histopathological findings reveals that the majority of the lesions 58.7% with apparent diffusion coefficient (ADC) value≤1.03 x10-3 mm2/s (P <.005). Diffusion weighted imaging (DWI) analysis showed a sensitivity of 73.68%, a specificity of 88.88%, a PPV of 83.25%, an NPV of 82.75% and an accuracy of 82.60%. Conclusion: Diffusion weighted imaging (DWI) MRI is a non invasive technique used to discriminate benign and malignant lesions and helps in reducing unnecessary interventions.