The Application Value of Time-Dependent DWI in the Differential Diagnosis of Benign and Malignant Breast Lesions and Microstructural Feature Analysis

Objective This study aimed to evaluate the diagnostic value of various ADC sequences and microstructural parameters derived from time-dependent diffusion-weighted imaging (td-DWI) in differentiating benign and malignant breast lesions. Methods In this study, a total of 52 patients with breast lesions were included, comprising 24 cases of benign lesions and 28 cases of malignant lesions. MRI examinations were conducted to measure four ADC values: ADC_25HZ, ADC_50HZ, ADC_PGSE, and ADC_Zoomit. Additionally, microstructural parameters fin, Dex, d, and Cellularity were calculated. Clinical and imaging characteristics between two groups were compared using independent samples t-tests and chi-square tests, and the diagnostic performance of each parameter was evaluated. Results Age, maximum diameter, FGT, morphology, TIC curve, edema, T2WI signal, DWI signal, and BI-RADS score showed significant differences between the benign and malignant groups (p < 0.05). The differences in ADC_25HZ, ADC_PGSE, and ADC_Zoomit between the two groups were statistically significant (p = 0.042, 0.020, < 0.001), with ADC_Zoomit exhibiting the highest AUC of 0.808. Among the microstructural parameters, fin, Dex, and d showed significant differences between the groups (p = 0.005, 0.001, < 0.001), with d having the highest AUC of 0.816 and an accuracy, specificity, and sensitivity of 0.769, 0.792, and 0.75, respectively. Conclusion td-DWI, particularly when combined with high-frequency oscillating gradients and advanced post-processing algorithms, offers a robust and non-invasive method for the early detection and precise characterization of breast lesions. This approach shows significant promise for improving breast cancer diagnosis and guiding personalized treatment strategies, ultimately enhancing patient outcomes.