Dynamic MR and diffusion-weighted imaging in the assessment of postoperative changes after breast-conserving surgery

Background Dynamic MRI and diffusion-weighted imaging (DWI) are two advanced imaging modalities that provide valuable insights into breast tissue’s morphological and functional aspects. Aim To evaluate the ability of DWI and dynamic MRI as a noninvasive sequence to detect postoperative changes following conservative surgical procedures. Patients and methods Our study was performed on 40 female patients previously operated with conservative surgery (lumpectomy) for breast cancer. They presented with suspicious findings on ultrasound and/or mammography either due to symptoms or on routine follow-up. Results There was a significant difference between benign and malignant lesions in the number of lesions not located at the operative bed. Malignant lesions had statistically significant higher hyperintense lesions in Short Tau Inversion Recovery images and showed a statistically higher incidence of diffusion restriction as appeared from the DWI compared with benign lesions. ADC (10 -3 mm 2 /s) values showed significant predictive value of malignant lesions ( P <0.001) with an area under the curve of 0.952. An ADC cutoff value of less than or equal to 1.13 could predict malignant lesions with a sensitivity of 90% and specificity of 93.9%. Conclusion The combination of dynamic MR and DWI represented a robust approach for postoperative evaluation and was a powerful tool for distinguishing benign and malignant lesions, with a high sensitivity and specificity level.