Latest Updates in the Efficiency of the Novel MRI Technique Diffusion Weighted Imaging with Background Signal Suppression (DWIBS) in Comparison to Dynamic Contrast Enhancing MRI Technique in Clarifying Suspicious Breast Lesions.
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Abstract
Background:
Breast cancer is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed only in 2012 (second most common cancer overall). This represents about 12% of all new cancer cases and 25% of all cancers in women.
Cancer care has become more individualized for patients, and thus, better characterization for treatment planning is required.
Sono-mammography has been widely used but due to its low sensitivity, other methods were required, and biopsy was needed as the gold standard test. A newly introduced MRI sequence DWIBS allows the acquisition of volumetric diffusion weighted images with high lesion-to-background contrast, hence making the use of contrast material unnecessary and thought to decrease the rate of unnecessary biopsies
Results:
In our study the selected patients underwent both dynamic contrast enhanced MRI technique (DCE) & Diffusion weighted imaging with background signal suppression (DWIBS).
DWIBS found to be better than DCE in its sensitivity and negative predictive value; measuring 97.47% and 95.24%, compared to 94.7% and 91.7% respectively, yet DCE showed higher specificity and PPV measuring 95.7% and 97.39% compared to 87% and 92.5% for DWIBS respectively.
DWIBS valuable role was assessed in terms of its higher ability than DCE to detect the lesions correlated with the histopathological findings where DWIBS could detect 97.47% of the lesions included in our study, on the other side DCE detected 94.7% of the lesions.
Conclusion:
In our study, we found that DCE-MRI and DWIBS showed comparable results as regards to their sensitivity and specificity. DWIBS however showed higher sensitivity and negative predictive value than DCE , thus it can be very useful screening tool without the need for a lengthy MRI procedure or the need for IV contrast administration.