Abstract

Diffusion Weighted Imaging (DWI) is a Magnetic Resonance Imaging (MRI) sequence that can characterize the overall movement of water to assess indirectly the microstructure inside a tissue. The objective of our study is to determine, in a systematic review, the diagnostic performance of quantitative DWI in high risk and newly diagnosed patients with breast lesions. English trials published between 2008 and 2018 were assessed to evaluate the diagnostic power of quantitative DWI in patients with breast lesions were revised and summarized regarding the inclusion and exclusion criteria in addition to characteristics of the lesions and the histopathological findings at morphological and/or dynamic levels. Among 96 eligible studies, covering a total of 649 patients and 771 breast lesions, of which, 401 were malignant and 370 were benign. 12 study were included in this systematic review that was published between 2008 and 2018, mean Apparent Diffusion Coefficient (ADC) measures of malignancy were ranging between 0.88 and 1.42 × 10-3 mm2/s. The mean ADC measure of benign lesions lied between 1.00 and 1.87 × 10-3 mm2/s. Quantitative DWI has a better specificity to distinguish between benign and malignant breast lesions in comparison to that of contrast-enhanced MRI. Though, large multi-center randomized control trials are needed to evaluate its clinical impact because of varying diffusion gradient factor and diagnosis threshold.

Key words: Breast cancer; Diffusion-weighted imaging