J Korean Soc Radiol.  2010 Jun;62(6):585-591.

Comparison of Diffusion Weighted Imaging and Contrast Enhanced Imaging on MRI for Breast Lesions

• Choi JJ
• Kang BJ
• Cha ES
• Kim SH
• Lee JH
• Jeh SK
• Park MY
• Jeong SH
• Yim HW

Abstract

PURPOSE
To retrospectively compare the MRI findings of diffusion-weighted imaging (DWI) and contrast-enhanced imaging (CEI) of breast lesions.
MATERIALS AND METHODS
From June 2005 to June 2007, 159 patients with 159 biopsy-proven breast lesions underwent breast MRIs including DWI and CEI. Two breast imaging radiologists reviewed the MRI findings by consensus for the presence of a high signal intensity on DWI and enhancement on CEI. The MRI findings and concordance of DWI and CEI findings were correlated with the pathologic diagnosis.
RESULTS
Of the 159 lesions 141 were malignant and 18 were benign. The sensitivity and specificity of DWI for detecting breast cancer was 96.5% (135/141) and 21.4% (5/18), respectively, compared to CEI, whose detection rate was 99.3% (140/141) and 33.3% (6/18), respectively. Larger lesions (> 1 cm) were more frequently detected by DWI. Of the enhanced malignancy, 96.4% (135/140) showed high signal intensity on DWI. The concordance of DWI and CEI findings in malignant lesions was significantly higher than benign lesions (95.7% vs. 61.1%, p<0.0001).
CONCLUSION
High signal intensity on diffuse-weighted MRI shows a high degree of sensitivity for detecting breast cancer.

MeSH Terms

Breast
Breast Neoplasms
Consensus
Diffusion
Humans
Magnetic Resonance Imaging
Retrospective Studies
Sensitivity and Specificity

Figure

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  Fig. 1 Invasive ductal carcinoma of 56-year-old women. A. Contrast enhanced axial T1-weighted image shows an enhancing mass with irregular margin in left breast. B. Sagittal contrast enhanced T1-weighted image of left breast shows a rim-enhancement of the mass. C. Diffusion weighted image shows the mass as high-signal intensity mass in left breast.

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  Fig. 2 A 0.9 cm invasive ductal carcinoma of 49-year-old women. A. Contrast enhanced axial T1-weighted image shows a small enhancing mass in right breast (arrow). B. Diffusion weighted image shows a high-signal intensity focus in right breast (arrow).

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  Fig. 3 Ductal carcinoma in situ of 65-year-old women. A. Contrast enhanced axial T1-weighted image show a nonmass enhancement with segmental distribution in left breast (arrow). B. Diffusion weighted image demonstrated no high signal intensity in left breast (arrow).

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  Fig. 4 Ductal carcinoma in situ of 46-year-old women. A, B. Contrast enhanced axial and sagittal T1-weighted images show architectural distortion without enhancement in right breast (arrows). C. The lesion demonstrated focal high signal intensity on diffusion weighted image (arrow).

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