This prospective study included 37 patients with 39 breast lesions. DWI images were acquired at 2 b values (200, 1500s/mm²) on a 3T-MRI scanner with a dedicated 16-channel breast coil. From the images a non-Gaussian diffusion based absolute quantitative biomarker, so-called Signature Index (S-index), was calculated by comparing tissue signals to a library of tissue reference signals to provide a classification of tumor types. The median S-index for malignant lesions was significantly higher (p < 0.0001) than for benign lesions, and the overall S-index diagnostic performance was significantly higher than BI-RADS (AUC=0.96 and 0.83, respectively), without contrast agents.
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