Value of kinetic parameters of ultra-fast dynamic contrast-enhanced magnetic resonance inaging (MRI) for differentiating malignant and benign breast lesions: a retrospective study.

AIM: The aim of this study was to evaluate the diagnostic value of ultra-fast dynamic contrast-enhanced magnetic resonance imaging (UF DCE-MRI) kinetic parameters in differentiating benign and malignant breast lesions. MATERIALS AND METHODS: A total of 194 patients (194 lesions: 94 malignant and 100 benign) were retrospectively recruited between February 2024 and June 2025 and divided into a training set (n = 139) and a test set (n = 55). All patients underwent UF DCE-MRI. In the training set, differences in maximum slope (MS), time to enhancement (TTE), area under the curve (AUC), and maximum peak of the curve (MPC) between benign and malignant lesions were compared. Furthermore, these parameters were analysed in both mass enhancement (ME) and non-mass enhancement (NME) subgroups. Subsequently, the optimal cut-offs derived from the training set were applied to the test set to calculate the classification accuracy of each parameter. A receiver operating characteristic (ROC) curve analysis was performed, with a P value <0.05 considered statistically significant. RESULTS: All four parameters differed significantly between benign and malignant lesions (all P < .05). Notably, while TTE exhibited statistical significance; its diagnostic efficacy was limited (area under the receiver operating characteristic curve [ROC-AUC]: 0.37), whereas MS, AUC, and MPC achieved favourable discriminative ability (ROC-AUC: 0.80, 0.82, 0.79). In subgroup analysis, these three parameters remained significantly different between benign and malignant breast lesions in ME (all P < .05), but no significant differences were observed in NME (all P > .05). Consistently, they demonstrated high diagnostic efficacy in the test set (ROC-AUC: 0.80, 0.83, 0.80; sensitivity: 0.84, 0.89, 0.84; specificity: 0.78, 0.78, 0.86). CONCLUSION: UF DCE-MRI kinetic parameters are promising for differentiating benign and malignant breast lesions, with particular efficacy in ME lesions.