Intraobserver and interobserver variability in the calculation of apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (DW-MRI) of breast tumours

Purpose This study evaluated intraobserver and interobserver variability in the measurement of apparent diffusion coefficient (ADC) values in breast carcinomas. Materials and methods Twenty-eight patients with solid breast lesions >10 mm underwent conventional contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted MRI (DW-MRI). Two observers (expert and trainee) segmented the lesion from the surrounding breast tissue on DW images with high b-value (1,000 s/mm2). This analysis was repeated by the expert reader after 6 months. Volumes were analysed to obtain mean, median and standard deviation (SD) of the ADC values. Interobserver and intraobserver variation was analysed using the Bland-Altman graph. Results All lesions were breast carcinomas, with a mean ADC value of 1.07 7 10 123 mm2/s. The mean of the differences was 0.012 7 10 123 mm2/s, corresponding to an intraobserver variability of 1.1% (limits of agreement: 125%/+8%). The mean interobserver difference was 0.022 7 10 123 mm2/s, corresponding to an interobserver variability of 2% (limits of agreement: 129%/+14%). Conclusions We found a low intraobserver and interobserver variability in calculating ADC in breast carcinomas, which supports its potential use in routine clinical practice