The ACRIN 6702 trial confirmed that standard ADCs from multi b-value DWI acquisition are lower in malignancies than in benign lesions and that application of standard ADCs can eliminate one in five unnecessary biopsies. Secondary analysis from this trial demonstrated that application of alternate ADC metrics, including perfusion insensitive ADCØ and normalized ADC provide no practical benefit over standard ADC for improving conventional DCE-MRI performance. These findings suggest that standard ADC calculations alone are sufficient for improving breast MRI specificity and should be the primary metric included in the next edition of the BI-RADS atlas.
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