E-ISSN 2587-0831
Original Article
Dual-Phase ADC Modelling of Breast Masses in Diffusion-Weighted Imaging: Comparison with Histopathologic Findings
1 Department of Biomedical Engineering, Yeditepe University, İstanbul, Turkey  
2 Institute of Diagnostic and Interventional Radiology, Oberlausitz-Kliniken gGmbH, Bautzen, Germany  
3 Department of Radiology, Marmara University School of Medicine, İstanbul, Turkey  
4 Department of Radiology, Acıbadem Altunizade Hospital, İstanbul, Turkey  
Eur J Breast Health 2018; 14: 85-92
DOI: 10.5152/ejbh.2018.3829
Key Words: Breast, diffusion-weighted imaging, apparent diffusion coefficient, dual-phase


Objective: To investigate the diagnostic value of dual-phase apparent diffusion coefficient (ADC) compared to traditional ADC values in quantitative diffusion-weighted imaging (DWI) for differentiating between benign and malignant breast masses.


Materials and Methods: Diffusion-weighted images of pathologically confirmed 88 benign and 85 malignant lesions acquired using a 3.0T MR scanner were analyzed. Small region-of-interests focusing on the highest signal intensity of lesions were used. Lesion ADC estimates were obtained separately from all b-value images (ADC; b=50, 400 and 800s/mm2), lower b-value images (ADClow; b=50 and 400s/mm2) and higher b-value images (ADChigh; b=400 and 800s/mm2). A set of dual-phase ADC (dpADC) models were constructed using ADClow, ADChigh and a perfusion influence factor ranging from 0 to 1.


Results: Strong positive correlation is observable between ADC and all dpADCs (ρ=0.80-1.00). Differences in ADC and dpADCs between the benign and the malignant lesions are all significant (p<0.05). In detecting malignancy, traditional lesion ADC provides a good performance (AUC=89.9%) however dpADC0.5 (dpADC with a factor of 0.5) accomplishes a better performance (AUC=90.8%). At optimal thresholds, ADC achieves 94.1% sensitivity, 72.7% specificity and 83.2% accuracy while dpADC0.5 leads to 92.9% sensitivity, 79.5% specificity and 86.1% accuracy.


Conclusion: Dual-phase ADC modelling may improve the accuracy in breast cancer diagnosis using DWI. Further prospective studies are needed to justify its benefit in clinical setting.


Cite this article as: Ertaş G, Onaygil C, Buğdaycı O, Arıbal E. Dual-Phase ADC Modelling of Breast Masses in Diffusion-Weighted Imaging: Comparison with Histopathologic Findings. Eur J Breast Health 2018; 14: 85-92.

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