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Abstract

Objective: To compare the evaluation of diffusion weighted MRI and ultrasonography in the detection of breast lesions.
Study design: It was a Cross-Sectional Comparative Study.
Place and duration of study: The study was conducted at at Islamabad Diagnostic Center, Faisalabad from July 2024 to December 2024.
Material and Methods: A sample size of 97 patients presenting with breast lesions was selected, excluding those with previous breast implant. All patients underwent MRI using a 1.5 Tesla machine and statistical analysis was performed using SPSS version 25.
Results: This study included 97 patients with breast lesions to compare the diagnostic performance of ultrasonography (US) and diffusion-weighted MRI (DWI). Based on US, 39 patients (40.2%) were classified as BI-RADS 2, 32 (33.0%) as BI-RADS 3, 6 (6.2%) as BI-RADS 4, 8 (8.2%) as BI-RADS 5, and 12 (12.4%) as BI-RADS 6. Among 33 malignant lesions, MRI accurately detected 31, yielding a sensitivity of 93.9%. MRI correctly identified 9 out of 10 malignant lesions in BI-RADS 3 (90.0% accuracy), 3 out of 4 in BI-RADS 4 (75.0% accuracy), and all malignant cases in BI-RADS 5 and 6 (100% accuracy). DWI detected 100% of vascular lesions as hyperintense and 91% of non-vascular lesions as hypointense, demonstrating high specificity for malignancy. MRI outperformed US in identifying malignancies, particularly for vascular lesions, whereas US was more accurate for benign lesion detection. These findings reinforce the complementary role of both modalities in breast lesion characterization.