Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Purpose:The purpose of this study is to assess diagnostic performance and accuracy of diffusion weighted imaging with background signal suppression (DWIBS) compared with contrast enhanced mammography in diagnosis of breast lesions and correlate the findings with the histopathological results. Patients and methods :52 female patients were enrolled in the study their age ranged between 23-77 years old, mean age is about (47.83,+/-SD=11.55)years . All patients presented with BIRADS 3,4 and 5 lesions categorized by mammography and US . They were assessed by both contrast enhanced mammography and DWIBS MR.Each detected lesion was specified according to the BI-RADS classification, localization, and lesion size (maximum diameter) as well as the presence of additional sites of disease on both modalities.The imaging findings were correlated with the pathologic results. Results :The primary unit of analysis was the lesion ,54 lesions were detected in 52 cases.39/54 of the lesions were histopathologically proven as malignant and 15/54 were benign. The overall sensitivity of mammography, CEDM and DWIBS-MRI was 92.3%, 100% and 94.90% respectively .Their specificity was 60%,73.30% and 93.30% respectively. The area under the ROC curve was higher for DWIBS MRI (97.4%) than that was for CEDM (90.4 %) using BIRADS analysis The area under the ROC curve was higher for DWIBS MRI (97.4%) than that was for CEDM (90.4 %) using BIRADS analysis . So, DWIBS is betterin characterization of breast lesions.The cut off value of ADC for differentiation of benign from malignant lesions was suggested to be 1.15 {u00D7} 10{u2212}3 mm2with sensitivity of 94.90%, specificity of 80%The AUC was (AUC) = 0.913 with (95% Confidence Interval)

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