Numerous single-site studies have established that diffusion-weighted MRI (DWI) can improve breast MRI performance, but clinical implementation has been limited by lack of standardization. The ECOG-ACRIN multicenter A6702 trial determined two pre-specified ADC thresholds from standardized acquisition that could reduce unnecessary biopsies by up to 36%. Since lesion ADCs were computed using centralized offline analysis, whether similar performance could be achieved in clinical settings is not yet established. We demonstrate that implementing the ADC threshold specified by the ECOG-ACRIN trial in a clinical breast imaging setting could provide high sensitivity and potentially reduce unnecessary biopsies for screening breast MRI.
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