Microstructural Characterization of Breast Lesion Subtypes Using Time-Dependent Diffusion MRI: A Multicenter Study

RATIONALE AND OBJECTIVES: To evaluate the diagnostic performance of microstructural parameters derived from time-dependent diffusion MRI (Td-dMRI) with the oscillating gradient spin-echo (OGSE) in differentiating breast lesion subtypes. MATERIALS AND METHODS: Patients with clinically diagnosed breast lesions were enrolled from two centers between March 2024 and May 2025. All patients underwent conventional MRI and Td-dMRI examinations. The IMPULSED model was applied to fit Td-dMRI data for extracting microstructural parameters. Lesions were divided into two groups (benign vs malignant) and three groups (benign lesions, in situ carcinoma, invasive carcinoma) for comparative analysis. The diagnostic performance of these parameters was assessed using the area under the ROC curve. Univariate and multivariate logistic regression analyses were performed to evaluate the associations between microstructural parameters and lesion subtypes. RESULTS: were observed between benign lesions and carcinoma in situ (P = .004 to .013). CONCLUSION: Td-dMRI combined with OGSE technology shows potential for effectively differentiating benign from malignant breast lesions. Moreover, the derived microstructural parameters may help facilitate the distinction between benign lesions and carcinoma in situ.