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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(02): 229-236
DOI: 10.4103/ijri.IJRI_405_16
Breast

Role of exponential apparent diffusion coefficient in characterizing breast lesions by 3.0 Tesla diffusion-weighted magnetic resonance imaging

Shweta Kothari
Department of Radio Diagnosis, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
,
Archana Singh
Department of Radio Diagnosis, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
,
Utpalendu Das
Department of Radio Diagnosis, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
,
Diptendra K Sarkar
Department of Surgery, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
,
Chhanda Datta
Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
,
Avijit Hazra
Department of Pharmacology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Objective: To evaluate the role of exponential apparent diffusion coefficient (ADC) as a tool for differentiating benign and malignant breast lesions. Patients and Methods: This prospective observational study included 88 breast lesions in 77 patients (between 18 and 85 years of age) who underwent 3T breast magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) using b-values of 0 and 800 s/mm2 before biopsy. Mean exponential ADC and ADC of benign and malignant lesions obtained from DWI were compared. Receiver operating characteristics (ROC) curve analysis was undertaken to identify any cut-off for exponential ADC and ADC to predict malignancy. P value of <0.05 was considered statistically significant. Histopathology was taken as the gold standard. Results: According to histopathology, 65 lesions were malignant and 23 were benign. The mean ADC and exponential ADC values of malignant lesions were 0.9526 ± 0.203 × 10−3 mm2/s and 0.4774 ± 0.071, respectively, and for benign lesions were 1.48 ± 0.4903 × 10−3 mm2/s and 0.317 ± 0.1152, respectively. For both the parameters, differences were highly significant (P < 0.001). Cut-off value of ≤0.0011 mm2/s (P < 0.0001) for ADC provided 92.3% sensitivity and 73.9% specificity, whereas with an exponential ADC cut-off value of >0.4 (P < 0.0001) for malignant lesions, 93.9% sensitivity and 82.6% specificity was obtained. The performance of ADC and exponential ADC in distinguishing benign and malignant breast lesions based on respective cut-offs was comparable (P = 0.109). Conclusion: Exponential ADC can be used as a quantitative adjunct tool for characterizing breast lesions with comparable sensitivity and specificity as that of ADC.

Keywords

Apparent diffusion coefficient - breast MRI - diffusion-weighted imaging - exponential apparent diffusion coefficient


Publication History

Article published online:
27 July 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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