Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional Study

Objective: To evaluate the role of diffusion-weighted MRI and to identify proper cut-off ADC value to differentiate benign from malignant breast lesions by correlating them with cytology/ histopathology examination. Apparent Diffusion Coefficient (ADC) is the objective measure of diffusion and is u...

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Main Authors: Srestha Khan, Senthil Kumar Aiyappan, Ragitha Ramesh, Shriram Natarajan, Ramya Sai Dachepalli, Nishant
Format: Article
Language:English
Published: KARACHI MEDICAL AND DENTAL COLLEGE 2024-11-01
Series:Annals of Abbasi Shaheed Hospital and Karachi Medical & Dental College
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Online Access:https://annals-ashkmdc.org/pre_install/1/index.php/ashkmdc/article/view/792
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author Srestha Khan
Senthil Kumar Aiyappan
Ragitha Ramesh
Shriram Natarajan
Ramya Sai Dachepalli
Nishant
author_facet Srestha Khan
Senthil Kumar Aiyappan
Ragitha Ramesh
Shriram Natarajan
Ramya Sai Dachepalli
Nishant
author_sort Srestha Khan
collection DOAJ
description Objective: To evaluate the role of diffusion-weighted MRI and to identify proper cut-off ADC value to differentiate benign from malignant breast lesions by correlating them with cytology/ histopathology examination. Apparent Diffusion Coefficient (ADC) is the objective measure of diffusion and is usually lower in malignant breast lesions. Methods: This was prospective cross-sectional research done in the Department of Radiodiagnosis involving 56 patients (with 82 breast lumps involving bilateral breasts). The breast lesions were identified by mammography, palpation, or B Mode ultrasonography. All these patients underwent MRI breast (Diffusion-weighted imaging). ADC mapping was done and ADC values were computed with the b values of 0, 800 & 1000. For every case that had an MRI, a histopathological or cytological confirmation was performed with the patient’s consent. The results of HPE/ cytology were correlated with MRI findings (Table/ Fig 1). Results: The mean ADC value among Malignant breast lesions has been 0.89 (±0.13) x10-3 mm2/s which is lower by 0.41 and statistically significant (P<0.05) compared to the ADC value of benign lesions which was 1.3 (±0.13) x10-3 mm2/s. The AUC for the value of ADC in predicting malignancy was 0.965 (0.928 - 1). In this investigation, the ADC value cut-off of 1.05 x 10-3 mm2/s has been utilized to predict malignant and benign lesions. This value had a specificity of 93.0%, sensitivity of 92.30%, NPV (negative predictive value) of 93.22%, PPV (positive predictive value) of 92.28%, and accuracy of 92.67%. Conclusion: ADC value can be used as an efficient tool in the characterization of breast lesions with 1.05 x10-3 mm2/s as the best cut-off value for differentiating malignant tumors.
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spelling doaj-art-9a25f4dd0bf04205bce8c90106cc94c22025-08-20T03:12:49ZengKARACHI MEDICAL AND DENTAL COLLEGEAnnals of Abbasi Shaheed Hospital and Karachi Medical & Dental College1563-32412024-11-0129410.58397/ashkmdc.v29i4.792Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional StudySrestha Khan0Senthil Kumar Aiyappan1Ragitha Ramesh2Shriram Natarajan3Ramya Sai Dachepalli 4Nishant5SRM Medical college and hospital, Chengalpattu, Tamil NaduSRM Medical college and hospital, Chengalpattu, Tamil NaduSRM medical college hospital and research centreSRM Medical college and hospital, Chengalpattu, Tamil NaduSRM Medical college and hospital, Chengalpattu, Tamil NaduSRM Medical college and hospital, Chengalpattu, Tamil Nadu Objective: To evaluate the role of diffusion-weighted MRI and to identify proper cut-off ADC value to differentiate benign from malignant breast lesions by correlating them with cytology/ histopathology examination. Apparent Diffusion Coefficient (ADC) is the objective measure of diffusion and is usually lower in malignant breast lesions. Methods: This was prospective cross-sectional research done in the Department of Radiodiagnosis involving 56 patients (with 82 breast lumps involving bilateral breasts). The breast lesions were identified by mammography, palpation, or B Mode ultrasonography. All these patients underwent MRI breast (Diffusion-weighted imaging). ADC mapping was done and ADC values were computed with the b values of 0, 800 & 1000. For every case that had an MRI, a histopathological or cytological confirmation was performed with the patient’s consent. The results of HPE/ cytology were correlated with MRI findings (Table/ Fig 1). Results: The mean ADC value among Malignant breast lesions has been 0.89 (±0.13) x10-3 mm2/s which is lower by 0.41 and statistically significant (P<0.05) compared to the ADC value of benign lesions which was 1.3 (±0.13) x10-3 mm2/s. The AUC for the value of ADC in predicting malignancy was 0.965 (0.928 - 1). In this investigation, the ADC value cut-off of 1.05 x 10-3 mm2/s has been utilized to predict malignant and benign lesions. This value had a specificity of 93.0%, sensitivity of 92.30%, NPV (negative predictive value) of 93.22%, PPV (positive predictive value) of 92.28%, and accuracy of 92.67%. Conclusion: ADC value can be used as an efficient tool in the characterization of breast lesions with 1.05 x10-3 mm2/s as the best cut-off value for differentiating malignant tumors. https://annals-ashkmdc.org/pre_install/1/index.php/ashkmdc/article/view/792Breast carcinomaADC,Diffusion Weighted ImagingDWI,Benign breast lesion.
spellingShingle Srestha Khan
Senthil Kumar Aiyappan
Ragitha Ramesh
Shriram Natarajan
Ramya Sai Dachepalli
Nishant
Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional Study
Annals of Abbasi Shaheed Hospital and Karachi Medical & Dental College
Breast carcinoma
ADC,
Diffusion Weighted Imaging
DWI,
Benign breast lesion.
title Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional Study
title_full Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional Study
title_fullStr Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional Study
title_full_unstemmed Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional Study
title_short Diagnostic Accuracy of Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions: A Cross-Sectional Study
title_sort diagnostic accuracy of diffusion weighted imaging in differentiating benign and malignant breast lesions a cross sectional study
topic Breast carcinoma
ADC,
Diffusion Weighted Imaging
DWI,
Benign breast lesion.
url https://annals-ashkmdc.org/pre_install/1/index.php/ashkmdc/article/view/792
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AT senthilkumaraiyappan diagnosticaccuracyofdiffusionweightedimagingindifferentiatingbenignandmalignantbreastlesionsacrosssectionalstudy
AT ragitharamesh diagnosticaccuracyofdiffusionweightedimagingindifferentiatingbenignandmalignantbreastlesionsacrosssectionalstudy
AT shriramnatarajan diagnosticaccuracyofdiffusionweightedimagingindifferentiatingbenignandmalignantbreastlesionsacrosssectionalstudy
AT ramyasaidachepalli diagnosticaccuracyofdiffusionweightedimagingindifferentiatingbenignandmalignantbreastlesionsacrosssectionalstudy
AT nishant diagnosticaccuracyofdiffusionweightedimagingindifferentiatingbenignandmalignantbreastlesionsacrosssectionalstudy