Diagnostic interplay of proton magnetic resonance spectroscopy and diffusion weighted images with apparent diffusion coefficient values in suspicious breast lesions

Aim of the work

To study the diagnostic performance of combined single voxel 1H-MRS and DW-MRI with ADC values as a non-contrast diagnostic tool, compared to the DCE-MRI, in suspicious breast lesions.

Materials and methods

113 female patients (mean age 45.8?years) with suspicious breast lesions, categorized as BI-RADS 3 or 4 by sono-mammographic examinations, were subjected to bilateral breast imaging with non-contrast MRI including conventional MRI, DW-MRI with quantitative ADC values, and single voxel 1H-MRS, in addition to DCE-MRI. They had 132 pathologically proved lesions (74 benign and 58 malignant).

Results

DW-MRI with ADC values was 96.97% accurate with 94.92% sensitivity and 98.63% specificity, while DCE-MRI was 97.73% accurate with 98.29% sensitivity but with 97.29% specificity, and 1H-MRS was 98.48% accurate with the highest sensitivity (100%) and 97.33% specificity. Furthermore, the combined use of DW-MRI with ADC values and 1H-MRS improved the diagnostic capability than utilization of each sequence alone with the highest accuracy of 99.24%, 100% sensitivity and 98.65% specificity.

Conclusion

The combined use of DW-MRI with quantitative ADC data and single-voxel 1H-MRS is a reliable non-contrast tool that provides higher accuracy in characterizing suspicious breast, and can efficiently be used in the absence of DCE-MRI.