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This article is part of the supplement: Royal College of Radiologists Breast Group Annual Scientific Meeting 2010

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Effect of region of interest size in quantitative diffusion-weighted magnetic resonance imaging of the breast

N AlRashidi*, T Gagliardi, T Ahearn, T Redpath and F Gilbert

  • * Corresponding author: N AlRashidi

Author Affiliations

University of Aberdeen, UK

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Breast Cancer Research 2010, 12(Suppl 3):P19  doi:10.1186/bcr2672

The electronic version of this article is the complete one and can be found online at:

Published:25 October 2010

© 2010 AlRashidi et al; licensee BioMed Central Ltd.


In breast MRI, morphological and dynamic enhancement features determine whether a lesion is benign or malignant but specificity is low. Diffusion-weighted magnetic resonance imaging (DW-MRI) measures microscopic motion of water and gives quantitative measurement known as the apparent diffusion coefficient (ADC). This study was conducted to determine whether the whole of the lesion should be included within the region of interest (ROI) or whether a small ROI would differentiate benign from malignant disease.


Fifteen female patients with 15 suspicious lesions were imaged on a 3T MRI machine (Philips HealthCare, Best, the Netherlands). DWI-MRI was performed with b-values of 0, 150, 800 s/mm2 using single-shot SE-EPI (TR/ TE = 9,543 ms/50 ms). The ROI of the lesion and of fibroglandular tissue was used to calculate ADC values. Histology or follow-up data were available for all lesions.


The mean ADC value of malignant lesions (13) from two small ROIs was 0.954 ± 0.145 mm2/second and for benign (2) was 1.69 ± 0.17 mm2/ second (Figure 1a). The ADC values for the whole lesion were 1.027 ± 0.23 mm2/second and 1.78 ± 0.293 mm2/second, respectively (Figure 1b).

thumbnailFigure 1. Box plot of ADC values for benign, malignant and normal tissue using (a) two small ROIs and (b) a large ROI.


There is a significant difference between ADC values from large and small ROIs (P <0.05), with small ROIs giving greater differentiation. DWI is a promising technique to improve specificity of breast MRI.