Our proposed DWI reading method based on the BI-RADS lexicons from multiple b-value images had comparable specificity and NPV to the standard BI-RADS. The DWI reading method might increase diagnostic confidence in differentiating malignant and benign breast tumors. Excellent to substantial agreement was observed for DWI reading. Substantial-perfect agreement was observed in lesion characteristics and fibrograndular tissues, according to an adjusted BI-RADS lexicon for lesion classification. These results suggest that DWI reading methods might be applicable in a clinical setting, however, the agreement is moderate for non-mass lesions, which is still challenging for clinical application.
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