Classification of MRI-only suspicious breast lesions: Development and validation of a nomogram combining MRI features and ADC-based histogram

Motivation: MRI-only lesions tend to be small in size and often have limited specific morphologic features on MRI, posing a significant diagnostic challenge for clinicians. Goal(s): A simple, objective, and noninvasive approach is required to improve the diagnostic accuracy of MRI-only lesions. Approach: We aimed to develop and validate a nomogram combining clinicoradiologic features and ADC-based histogram parameters for MRI-only suspicious lesions. Results: Our results showed that ADC entropy in histogram parameters and kinetic pattern in clinicoradiologic parameters were identified as the most valuable predictors for differentiating MRI-only lesions, and a nomogram combining them exhibited better diagnostic performance than the two variables alone. Impact: A nomogram combining ADC entropy and kinetic pattern, as a simple, objective, and noninvasive tool, displays satisfactory diagnostic performance for MRI-only suspicious lesions and may be utilised to avoid unnecessary biopsy.