Comparison of the Sensitivity and Specificity of DWIBS and Contrast Enhanced T1Wi Sequences in Characterization of Suspicious Mammography Lesions

Abstract

Being the most common invasive cancer affecting females world-wide; early detection and proper treatment of breast cancer has always taken a high priority in scientific researches world-wide. Despite the marked improvement in the screening tools, in many cases histo-pathology is usually required. This may be the result of relatively high false-positive results of screening tools such as mammography. Despite its role in the detection of bilateral/ multi-centric tumors, DCE-MRI has considerable % of high false positive results. Another reason is that DCE-MRI is not feasible in all cases such as in cases of renal impairment since the injection of gadolinium based contrast requires adequate renal functions to avoid more serious renal impairment. This has created a growing need for a sensitive and specific screening and diagnostic imaging technique without the need for contrast injection. Conventional DWI (diffusion weighted imaging) with ADC maps has been proposed to increase the specificity of MRI if used as an adjunct to DCE-MRI. As a result of fallacies of diffusion, a new technique has been proposed which allows generation of ADC maps at higher b-values as well as allows suppression of the back-ground tissue of the breast depicting lesions more clearly. The technique is called DWIBS; diffusion weighted imaging with back-ground suppression.