Comparative Analysis of Quantitative and Semiquantitative Ultrafast DCE-MRI, Morphological Findings, and ADC in Breast Lesion Characterization

Abstract

Rationale and Objectives This study aimed to evaluate the diagnostic performance of quantitative and semiquantitative parameters obtained from ultrafast DCE-MRI in differentiating benign and malignant breast lesions, and to compare these parameters with morphological MRI findings and ADC values. Materials and Methods This single-center retrospective study was approved by the institutional ethics committee. Between January 2022 and May 2024, a total of 249 lesions (171 benign and 78 malignant) were evaluated using a protocol combining ultrafast DCE-MRI and conventional DCE-MRI. Quantitative parameters (K-trans, K-ep, Ve) and semiquantitative parameters (TTE, MS, iAUC60, TTP, PEI, APEI, TTMS, WOS45), morphological findings, and ADC values were analyzed. Results Univariate analyses showed that most semiquantitative parameters (TTE, MS, iAUC60, TTP, PEI, WOS45) significantly differed between benign and malignant lesions (all p < 0.001). In multivariate analysis, only TTP remained significant. Among the quantitative parameters, higher K-ep and K-trans values, and lower Ve values were strongly associated with malignancy (all p < 0.001). In multivariate analysis, only K-ep and K-trans retained significance. Quantitative parameters achieved the highest diagnostic accuracy (AUC 0.953), followed by morphological features (0.936) and ADC (0.913). TTP showed strong but slightly lower performance (0.855). Conclusion Quantitative parameters demonstrated superior diagnostic performance in distinguishing benign from malignant breast lesions compared with ADC, semiquantitative parameters, and morphological features.