The Role of Diffusion-Weighted Magnetic Resonance Imaging in Differentiating Benign and Malignant Breast Lesions: A Comprehensive Review

Abstract

Background: Breast magnetic resonance imaging (MRI) has emerged as a vital tool for detecting and characterizing breast lesions, particularly in differentiating benign from malignant tumors. This review explores the role of diffusion-weighted imaging (DWI) in breast MRI, highlighting its advantages over conventional imaging techniques. Methods: A systematic literature search was conducted across multiple databases, including PubMed and Scopus, to gather studies assessing DWI's sensitivity and specificity in breast cancer detection. Results: The findings indicate that DWI provides high diagnostic accuracy, with a pooled sensitivity of 86.5% and specificity of 83.5%, comparable to dynamic contrast-enhanced MRI (DCE-MRI). Notably, utilizing apparent diffusion coefficient (ADC) thresholds can minimize unnecessary biopsies without compromising sensitivity. However, challenges remain in achieving standardization in DWI protocols, particularly regarding b-value selection and imaging techniques, which impact ADC accuracy. Advanced methodologies such as intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) have shown promise in enhancing diagnostic capabilities by providing deeper insights into tissue microstructure. Conclusions: This review underscores the importance of ongoing standardization efforts and collaboration among institutions to improve the reliability and applicability of DWI in clinical settings. In conclusion, DWI represents a transformative approach to breast cancer management, allowing for enhanced differentiation of lesions while reducing the need for invasive procedures. Further research and standardization are essential to optimize its use in routine clinical practice.