Diagnostic value of synthetic diffusion-weighted imaging on breast magnetic resonance imaging assessment: comparison with conventional diffusion-weighted imaging.
Ebru Yılmaz, Nilgün Güldoğan, Sıla Ulus, Ebru Banu Türk, Mustafa Enes Mısır, Aydan Arslan, Mustafa Erkin Arıbal
Author Information
Ebru Yılmaz: Acıbadem Altunizade Hospital Breast Center, Department of Radiology, İstanbul, Türkiye ORCID
Nilgün Güldoğan: Acıbadem Altunizade Hospital Breast Center, Department of Radiology, İstanbul, Türkiye ORCID
Sıla Ulus: Acıbadem Ataşehir Hospital, Department of Radiology, İstanbul, Türkiye ORCID
Ebru Banu Türk: Acıbadem Altunizade Hospital Breast Center, Department of Radiology, İstanbul, Türkiye ORCID
Mustafa Enes Mısır: Acıbadem Mehmet Ali Aydınlar University, Department of Radiology, İstanbul, Türkiye ORCID
Aydan Arslan: University of Health Sciences Türkiye, Ümraniye Training and Research Hospital, Clinic of Radiology, İstanbul, Türkiye ORCID
Mustafa Erkin Arıbal: Acıbadem Mehmet Ali Aydınlar University, Department of Radiology, İstanbul, Türkiye ORCID
PURPOSE: To compare images generated by synthetic diffusion-weighted imaging (sDWI) with those from conventional DWI in terms of their diagnostic performance in detecting breast lesions when performing breast magnetic resonance imaging (MRI). METHODS: A total of 128 consecutive patients with 135 enhanced lesions who underwent dynamic MRI between 2018 and 2021 were included. The sDWI and DWI signals were compared by three radiologists with at least 10 years of experience in breast radiology. RESULTS: Of the 82 malignant lesions, 91.5% were hyperintense on sDWI and 73.2% were hyperintense on DWI. Of the 53 benign lesions, 71.7% were isointense on sDWI and 37.7% were isointense on DWI. sDWI provides accurate signal intensity data with statistical significance compared with DWI ( < 0.05). The diagnostic performance of DWI and sDWI to differentiate malignant breast masses from benign masses was as follows: sensitivity 73.1% [95% confidence interval (CI): 62-82], specificity 37.7% (95% CI: 24-52); sensitivity 91.5% (95% CI: 83-96), specificity 71.7% (95% CI: 57-83), respectively. The diagnostic accuracy of DWI and sDWI was 59.2% and 83.7%, respectively. However, when the DWI images were evaluated with apparent diffusion coefficient mapping and compared with the sDWI images, the sensitivity was 92.68% (95% CI: 84-97) and the specificity was 79.25% (95% CI: 65-89) with no statistically significant difference. The inter-reader agreement was almost perfect ( < 0.001). CONCLUSION: Synthetic DWI is superior to DWI for lesion visibility with no additional acquisition time and should be taken into consideration when conducting breast MRI scans. The evaluation of sDWI in routine MRI reporting will increase diagnostic accuracy.
