Abstract
Aim of the work: To study the diagnostic performance of combined single voxel 1H-MRS and DW-MRI with ADC values as a non-contrast diagnostic tool, compared to the DCE-MRI, in suspicious breast lesions.
Materials and methods: 113 female patients (mean age 45.8 years) with suspicious breast lesions, categorized as BI-RADS 3 or 4 by sono-mammographic examinations, were subjected to bilateral breast imaging with noncontrast MRI including conventional MRI, DW-MRI with quantitative ADC values, and single voxel 1H-MRS, in addition to DCE-MRI. They had 132 pathologically proved lesions (74 benign and 58 malignant).
Results: DW-MRI with ADC values was 96.97% accurate with 94.92% sensitivity and 98.63% specificity, while DCE-MRI was 97.73% accurate with 98.29% sensitivity but with 97.29% specificity, and 1H-MRS was 98.48% accurate with the highest sensitivity (100%) and 97.33% specificity. Furthermore, the combined use of DW-MRI with ADC values and 1H-MRS improved the diagnostic capability than utilization of each sequence alone with the highest accuracy of 99.24%, 100% sensitivity and 98.65% specificity.
Conclusion: The combined use of DW-MRI with quantitative ADC data and single-voxel 1H-MRS is a reliable noncontrast tool that provides higher accuracy in characterizing suspicious breast, and can efficiently be used in the absence of DCE-MRI.