Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in detection and characterization of neoplastic breast lesions

Abstract

Background: Breast cancer is a major health problem in women and early detection is of prime importance. Objective: We aimed to evaluate the role of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in detection of breast lesions and characterization of these detected lesions. Materials and methods: 40 female patients with clinically suspicious 50 breast lesions detected by sonomammography, in addition to the routine protocol that includes T1Wi's, T2Wi's, STIR, DCE-MRI, DWI sequences (with ADC maps) all the participants underwent DWIBS sequence (with ADC maps).The histopathology served as reference standard. First, we compared the detectability of breast lesions on DWIBS with that of the DWI. We then compared the ADCs of the malignant lesions (n=35) to that of the benign lesions (n=15) in both DWI and DWIBS. Results: Thirty seven lesions were detected via DWIBS (detectability of 74.0%) was less than that of DWI (detectability of 78.0%). In DWIBS, the mean ADC value of the malignant lesions (0.80 ± 0.27 × 10-3mm2/s) was significantly lower than that of the benign lesions (1.40 ± 0.41 × 10-3mm2/s). With a cut-off value of 1.3 × 10-3mm2/s for ADC, DWIBS achieved 85.7% sensitivity and 80% specificity for differentiating between benign and malignant lesions. Conclusion: Although it showed lower detectability for breast lesions than DWI, our study suggests that DWIBS is superior to DWI in the visualization of malignant breast lesion. Also based on ADC, DWIBS provides additional information that may further increase the specificity of breast lesion characterization.