Potential of MRI with diffusion weighted imaging in characterization of BIRADS IV Breast lesions in comparison with dynamic contrast-enhanced MRI

Background: MRI is becoming an essential tool for the assessment of breast pathology. Diffusion- weighted images provide quantitative and qualitative information reflecting the changes in tissue cellularity and integrity of cell membranes. Objectives: The aim of this study is to evaluate the diagnostic accuracy of DWI in the differentiation of BIRADs IV breast lesions and to assess the diagnostic performance of DWI as an adjunct to the dynamic enhanced breast MRI. Method: MRI unit, Radiology Department, Al-Sadr Teaching Hospital, Basra, performed a randomized prospective cross-sectional research on sixty female patients from April 2022 to February 2023. All patients with suspected breast lesions (BIRAD IV) found by ultrasonography or mammography. All had diffusion-weighted and dynamic contrast MRI. All individuals were examined using a Philips (Tesla 1.5). An experienced breast imaging radiologist analyzed the images before histology. Results: Thirty-seven malignant and twenty-three benign lesions were identified in 60 patients (mean age (of 18-64y). The mean ADC value for malignant lesions were (0.866±0.25 X 10-3 mm2/s) and for benign lesions were (1.40-0.11) with an observed significant difference of (P-value=0.023). The sensitivity and specificity of the Dynamic and DWI showed that DWI had a higher sensitivity (100%) compared to the Dynamic contrast study (94.6%) while regarding the specificity Dynamic had a higher specificity (100%) compared to DWI (95.7%). Conclusion: DWI is a short unenhanced scan that can be a potential adjunct to conventional breast MRI and can be used to accurately characterize breast lesions with high sensitivity and specificity.