ROLE OF DIFFUSION WEIGHTED MRI IN THE IMAGING OF BENIGN AND MALIGNANT BREAST LESIONS : A HOSPITAL BASED, CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL IN CENTRAL INDIA

Breast cancer remains a leading cause of morbidity and mortality among women worldwide, underscoring the need for accurate and non-invasive diagnostic tools. While mammography and ultrasound are first-line modalities, magnetic resonance imaging (MRI) has assumed a pivotal role, particularly with the addition of diffusion-weighted imaging (DWI). This hospital-based cross-sectional study evaluated the diagnostic utility of DWI and apparent diffusion coefficient (ADC) values in differentiating benign and malignant breast lesions. A total of 53 patients undergoing breast MRI were reviewed over 24 months, of whom 45 were included based on strict criteria. All underwent conventional MRI and DWI at bvalues of 0, 500, and 1000 s/mm², with findings correlated against histopathology. Of the 45 lesions, 21 were malignant and 24 benign. Malignant lesions consistently showed diffusion restriction and lower ADC values, with significant differences from benign lesions at both b-values. ROC analysis demonstrated superior diagnostic performance at b=1000 (AUC 0.948). Cohen's Kappa showed substantial agreement at b=500 (κ=0.73) and near-perfect agreement at b=1000 (κ=0.91). Discordant cases highlighted the value of higher b-values in reducing false positives. These results support the inclusion of DWI and ADC mapping, particularly at b=1000, in breast MRI protocols to enhance specificity, reduce unnecessary biopsies, and guide clinical decision-making.