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The aim of this study was to investigate the diagnostic performance of the perfusion-related parameters of intravoxel incoherent motion (IVIM) imaging for breast lesions, compared with dynamic contrast-enhanced magnetic resonance imaging (DCE MRI).Fifty-nine patients with both IVIM imaging and subsequent DCE MRI were enrolled. Perfusion-related parameters of IVIM imaging (perfusion fraction, f; pseudo–diffusion coefficient, D*), as well as model-based and model-free parameters of DCE MRI, were measured. Receiver operating characteristic curve analysis and correlations between the IVIM and DCE MRI parameters were performed.Thirty-one malignant and 35 benign lesions were pathologically proved. The area under the receiver operating characteristic curves (AUC) of D* plus f (AUCf+D*) was 0.834. The combined AUC of all model-based DCE MRI parameters (AUCmodel-based) was 0.904. The combined AUC of all model-free DCE MRI parameters (AUCmodel-free) was 0.876. AUCf+D* had no significant difference with either AUCmodel-based or AUCmodel-free. No significant correlation was found between f or D* and DCE-derived parameters.Intravoxel incoherent motion imaging has the same value in differentiating malignant and benign breast lesions, compared with DCE MRI, in terms of perfusion-related parameters.