Combined apparent diffusion coefficient value (ADC) and 1H magnetic resonance spectroscopy (MRS) in breast lesions: Benefits and limitations

Objective: This study aimed to assess the diagnostic value of a combined imaging protocol of diffusion-weighted MRI, apparent diffusion coefficient (ADC) values, and MR spectroscopy(MRS) in discriminating benign and malignant breast lesions. Patients and methods: twenty-six female patients complaining from breast lesions were included in this study. Diffusion weighted images, apparent diffusion coefficients value, and magnetic resonance spectroscopy were obtained to all patients. Results: Combined ADC value and MRS in discriminating benign breast lesions from malignant tumors were false-positive in 3 patients , true-positive in 14 patients, false-negative in 1 patient and true-negative in 8 patients with specificity of 72.7%, sensitivity of 93.3%, NPV of 88.9%, PPV of 82.4% and accuracy of 84.6%. Conclusion: A great advantage of ADC value is the significant difference between benign and malignant lesions, because of this it plays an important role in characterization of breast lesions. MRS is the only in vivo technique which can detect tissue metabolites. In our study combined MRS with ADC value increased sensitivity in detecting lesions, while the specificity remained at lower level than that of the ADC value alone