Authors Shreshta Khan SRM Medical college and hospital, Chengalpattu, Tamil Nadu Senthilkumar Aiyappan SRM Medical college and hospital, Chengalpattu, Tamil Nadu Ragitha Ramesh SRM medical college hospital and research centre Shriram Natarajan SRM Medical college and hospital, Chengalpattu, Tamil Nadu Ramya Sai Dachepalli SRM Medical college and hospital, Chengalpattu, Tamil Nadu Nishant SRM Medical college and hospital, Chengalpattu, Tamil Nadu DOI: https://doi.org/10.58397/ashkmdc.v29i4.792 Keywords: Breast carcinoma, ADC,, Diffusion Weighted Imaging, DWI,, Benign breast lesion. Abstract

Objective: To evaluate the role of diffusion-weighted MRI and to identify proper cut-off ADC value to differentiate benign from malignant breast lesions by correlating them with cytology/ histopathology examination. Apparent Diffusion Coefficient (ADC) is the objective measure of diffusion and is usually lower in malignant breast lesions.
Methods: This was prospective cross-sectional research done in the Department of Radiodiagnosis involving 56 patients (with 82 breast lumps involving bilateral breasts). The breast lesions were identified by mammography, palpation, or B Mode ultrasonography. All these patients underwent MRI breast (Diffusion-weighted imaging). ADC mapping was done and ADC values were computed with the b values of 0, 800 & 1000. For every case that had an MRI, a histopathological or cytological confirmation was performed with the patient’s consent. The results of HPE/ cytology were correlated with MRI findings (Table/ Fig 1).
Results: The mean ADC value among Malignant breast lesions has been 0.89 (±0.13) x10-3 mm2/s which is lower by 0.41 and statistically significant (P<0.05) compared to the ADC value of benign lesions which was 1.3 (±0.13) x10-3 mm2/s. The AUC for the value of ADC in predicting malignancy was 0.965 (0.928 - 1). In this investigation, the ADC value cut-off of 1.05 x 10-3 mm2/s has been utilized to predict malignant and benign lesions. This value had a specificity of 93.0%, sensitivity of 92.30%, NPV (negative predictive value) of 93.22%, PPV (positive predictive value) of 92.28%, and accuracy of 92.67%.
Conclusion: ADC value can be used as an efficient tool in the characterization of breast lesions with 1.05 x10-3 mm2/s as the best cut-off value for differentiating malignant tumors.

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