DCE Versus DWI in Breast Lesions Diagnosis

Today, Dynamic Contrast Enhancement is known as the standard MRI technique method for breast lesions imaging and breast masses screening. Despite the many advances that have been made in this method and its high capability in diagnosing and differentiating breast lesions, it can still be problematic and challenging DCE to perform. Also, this method has low specificity. In addition, due to the injection of contrast material in this method, it is not recommended for young patients and people who are allergic to MRI contrast materials. Diffusion Weighted Imaging is a technique based on the diffusion of water molecules in tissues. Tissues in which the diffusion of water molecules is restricted in this method have abnormal signals. Due to the presence of many membrane structures Pathological tissues have limited diffusion, therefore appear as high signal in DWI images. Another ability of this method is to quantitatively set ADC values in tissues using
ADC map images. Using DWI, the morphological structure and microstructures of the tissue can be quantitatively and qualitatively evaluated. This technique can be used to differentiate between benign and malignant masses. To quantitative assessment of ADC value and differentiate between malignant and benign lesions, it’s necessary a cutoff point of ADC value determine. According to cutoff value, different values of sensitivity are obtained. Unfortunately, the cutoff value of ADC for differentiation between benign and malignant lesions has not been standardized and its determination requires more studies in different centers and patients. In this article, we evaluate the different diagnosis and differentiation methods for breast lesions and compare them. Also, we evaluate and compare DCE and DWI techniques in breast lesions diagnosis and differentiation and try to provide suggestions for the cutoff value of ADC.