Objective:

To evaluate the value of histogram analysis of apparent diffusion coefficient (ADC) in differentiating benign breast lesions from malignancy.

Methods:

Ninety-one patients with breast masses were retrospectively analyzed (82 single and 8 multiple; 104 lesions in total; benign 25 and malignant 79). All patients received MR examination including enhanced

MRI and diffusion weighted imaging (DWI) and were confirmed by pathology. Histogram analysis of ADC maps was performed by using Medlab software to observe the histogram features of tumors and obtain the histogram parameters

including percentile ADC values

ADCmean

ADCmin

ADCmax

skewness and kurtosis. All parameters were analyzed by using t-test between benign and malignant groups

then the receiver operating characteristic (ROC) curves were constructed to observe the efficiency of differential diagnosis.

Results:

All ADC values were lower in malignant lesions than benign lesions

the differences in the above parameters except ADCmax (

P

=0.113) were statistically significant (

P

0.05). Skewness and kurtosis were higher in malignant lesions than benign lesions

but had no statistical significance (

P

=0.191 and 0.165

respectively). The areas under the ROC curves (AUCs) of 10th-50th ADCs were higher than ADCmean. The ACU of 25th ADC was the highest (0.814) at the cutoff value of 0.8810

-3

mm

2

/s

and the sensitivity and specificity were 0.88 and 0.696

respectively. The ACU of ADCmean was 0.79 at the cutoff value of 0.9210

-3

mm

2

/s

and the sensitivity and specificity were 0.92 and 0.658

respectively.

Conclusion:

ADC histogram analysis is valuable in differentiating benign breast lesions from malignancy by providing additional quantitative parameters.