title: Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of breast tumors.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the diagnostic value of an imaging protocol that combines dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with suspicious breast lesions and to determine if additional information provided by DWI improves the diagnostic value of breast MRI.
  
  
  METHODS
  Eighty-four patients with breast tumors (37 benign, 47 malignant) underwent DCE-MRI and DWI before biopsy. Morphologic and kinetic analyses were performed on DCE-MRI and findings were classified according to the BI-RADS lexicon. Apparent diffusion coefficient (ADC) values were calculated from the DWI. The ADCs of the benign and malignant lesions were compared. For the combined MRI protocol, morphologic kinetic features and ADCs were evaluated together. Diagnostic values of DCE-MRI, DWI, and combined MRI were calculated.
  
  
  RESULTS
  Median ADCs of the benign and malignant lesions were 1.26 × 10(-3) mm(2)/s and 0.75 × 10(-3) mm(2)/s, respectively. Cutoff value of 0.92 × 10(-3) mm(2)/s for ADC provided 91.5% sensitivity and 86.5% specificity. DCE-MRI alone showed 97.9% sensitivity and 75.7% specificity. The combination of DCE-MRI with DWI provided 95.7% sensitivity and 89.2% specificity. The specificity of breast MRI improved by 13.5% (p = 0.063) without a significant decrease in the sensitivity (p = 1.000).
  
  
  CONCLUSIONS
  The combination of DWI and DCE-MRI has the potential to increase the specificity of breast MRI.
authors.affiliation: Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey. sibel_ozy@yahoo.com
authors.forename: Sibel
authors.initials: S
authors.lastname: Kul
authors.forename: Aysegul
authors.initials: A
authors.lastname: Cansu
authors.forename: Etem
authors.initials: E
authors.lastname: Alhan
authors.forename: Hasan
authors.initials: H
authors.lastname: Dinc
authors.forename: Gurbuz
authors.initials: G
authors.lastname: Gunes
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Reis
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009942:Organometallic Compounds; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol