Differentiation of Benign and Malignant Breast Lesions Using ADC Values and ADC Ratio in Breast MRI

Silvia Tsvetkova; Katya Doykova; Anna Vasilska; Katya Sapunarova; Daniel Doykov; Vladimir Andonov; Petar Uchikov

doi:10.3390/diagnostics12020332

Differentiation of Benign and Malignant Breast Lesions Using ADC Values and ADC Ratio in Breast MRI

Diagnostics (Basel). 2022 Jan 27;12(2):332. doi: 10.3390/diagnostics12020332.

Authors

Silvia Tsvetkova¹, Katya Doykova¹, Anna Vasilska¹, Katya Sapunarova², Daniel Doykov³, Vladimir Andonov³, Petar Uchikov⁴

Affiliations

¹ Department of Diagnostic Imaging, Medical University Plovdiv, 15-A Vasil Aprilov Blvd, 4002 Plovdiv, Bulgaria.
² First Department of Internal Diseases, Medical University Plovdiv, 15-A Vasil Aprilov Blvd, 4002 Plovdiv, Bulgaria.
³ Second Department of Internal Diseases, Medical University Plovdiv, 15-A Vasil Aprilov Blvd, 4002 Plovdiv, Bulgaria.
⁴ Department of Special Surgery, Medical University Plovdiv, 15-A Vasil Aprilov Blvd, 4002 Plovdiv, Bulgaria.

Abstract

Magnetic resonance imaging (MRI) of the breast has been increasingly used for the detailed evaluation of breast lesions. Diffusion-weighted imaging (DWI) gives additional information for the lesions based on tissue cellularity. The aim of our study was to evaluate the possibilities of DWI, apparent diffusion coefficient (ADC) value and ADC ratio (the ratio between the ADC of the lesion and the ADC of normal glandular tissue) to differentiate benign from malignant breast lesions.

Materials and methods: Eighty-seven patients with solid breast lesions (52 malignant and 35 benign) were examined on a 1.5 T MR scanner before histopathological evaluation. ADC values and ADC ratios were calculated.

Results: The ADC values in the group with malignant tumors were significantly lower (mean 0.88 ± 0.15 × 10^-3 mm²/s) in comparison with the group with benign lesions (mean 1.52 ± 0.23 × 10^-3 mm²/s). A significantly lower ADC ratio was observed in the patients with malignant tumors (mean 0.66 ± 0.13) versus the patients with benign lesions (mean 1.12 ± 0.23). The cut-off point of the ADC value for differentiating malignant from benign breast tumors was 1.11 × 10^-3 mm²/s with a sensitivity of 94.23%, specificity of 94.29%, and diagnostic accuracy of 98%, and an ADC ratio of ≤0.87 with a sensitivity of 94.23%, specificity of 91.43%, and a diagnostic accuracy of 95%.

Conclusion: According to the results from our study DWI, ADC values and ADC ratio proved to be valuable additional techniques with high sensitivity and specificity for distinguishing benign from malignant breast lesions.

Keywords: ADC ratio; ADC value; DWI; breast MRI; breast lesions.