Diagnostic value of morphological features of breast lesions on DWI and T2WI assessed using Breast Imaging Reporting and Data System lexicon descriptors
ZHANG Liying
ZHANG Tongzhen
ZHAO Xin
Abstract：Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusion-weighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer.Methods We retrospectively reviewed the records of 394 consecutive patients with pathologically confirmed breast lesions who had undergone 3-T magnetic resonance imaging(MRI).The morphological characteristics of breast lesions were evaluated using DCE,DWI,and T2WI based on BI-RADS lexicon descriptors by trained radiologists.Patients were categorized into mass and non-mass groups based on MRI characteristics of the lesions,and the differences between benign and malignant lesions in each group were compared.Clinical prediction models for breast cancer diagnosis were constructed using logistic regression analysis.Diagnostic efficacies were compared using the area under the receiver operating characteristic curve(AUC)and DeLong test.Results For mass-like lesions,all the morphological parameters significantly differentiated benign and malignant lesions on consensus DCE,DWI,and T2WI(P<0.05).The combined method(DCE+DWI+T2WI)had a higher AUC(0.865)than any of the individual modality(DCE:0.786;DWI:0.793;T2WI:0.809)(P<0.05).For non-mass-like lesions,DWI signal intensity was a significant predictor of malignancy(P=0.036),but the model using DWI alone had a low AUC(0.669).Conclusion Morphological assessment using the combination of DCE,DWI,and T2WI provides better diagnostic value in differentiating benign and malignant breast mass-like lesions than assessment with only one of the modalities.
Keywords：breast cancermagnetic resonance imagingdiffusion-weighted imagingT2-weighted imagingdiagnostic accuracy
Publication Date：2025-09-20
Online Publishing Date：2025-10-10(First online date of this platform, not the publication date of the document)
Pages：9( 1809-1817 )