The Role of Dynamic Contrast Enhanced and Diffusion Weighted MRI in Characterization of Suspicious Breast Masses

Background: Early detection and diagnosis of breast cancer are mandatory for accurate management. Traditionally, mammography and ultrasound are the basic imaging techniques for the detection and localization of breast masses. The low sensitivity and specificity of these imaging tools resulted in a demand for new imaging modalities. Aim of study: to evaluate the role of either diffusion weighted images-MRI or dynamic contrast enhanced MRI in differentiating malignant from benign breast lesions comparing with histopathology results. Patients and Methods: from November 2016 to July 2017, a total of 20 patients presented with suspicious breast lesions BIRADS (4&5) were included in the study. All participants underwent breast DWI and DCE-MRI. Results were compared with histopathological results as a standard final diagnostic method. Results: the study included 20 female patients with suspicious breast lesions, there was 15 (75%) malignant lesions while benign lesions, while benign lesions were 5 (25%) cases. DCE-MRI was found to have a sensitivity of 86.7% and specificity of 80%. ADC cutoff value was found to have a value of 1.143*10-3, which was the best to differentiate between benign and malignant breast masses. DWI MRI was found to have sensitivity of 93.3% and a specificity of 80%. Conclusion: DW-MRI alone gave the same performance as in combination with DCE-MRI. The comparison of DWI and DCE-MRI provides a dramatic superiority in the sensitivity, specificity and accuracy of breast DWI-MRI over other modality.