الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most common cancer in females and second cause of death due to cancer after lung cancer. Prognosis and five-year survival rate of breast cancer depend largely on early detection.
The role of radiologist in detection of breast cancer and its staging increased all over the years. While MRI breast has been established as important diagnostic imaging study for breast cancer with known clinical indications, continuous researches and emerging techniques are carried out, aiming for increasing its specificity.
This study aimed to evaluate the value of added diffusion tensor imaging to 3-T MRI breast in differentiation between benign breast lesions and malignant lesions and to test its diagnostic performance.
The study was performed from June 2018 to January 2020. It included 50 female patients who were referred to the MRI unit of the Radio-diagnosis and intervention department of Alexandria main university hospital planned for MRI breast. All patients were presented with breast or axillary complain confirmed by clinical examination and followed by further assessment by mammogram and/or ultrasound breast. DCE-MRI breast was done with added diffusion tensor imaging (DTI).
The most common incidence of malignant breast lesions was detected in age ranging from 45 to 65 years; 20 patients out of 31 malignant cases (64.5%).
Regarding clinical presentation, breast lump was the commonest (50% of the cases) followed by nipple discharge (20 % of the cases).
After detailed interpretation and processing of the morphological and dynamic imaging features of the MRI- detected lesions according to latest BIRADS lexicon, FA map was generated from DTI, as it is the most clinically used diffusion tensor parameter.
Values of both ADC and FA of the detected lesions were measured and cut off values of ADC and FA for discrimination between benign lesions and malignant ones were estimated using ROC curve and resulted into cut off value 1 x10 -3 mm2 /sec for the ADC and 0.2 for FA values then correlated with the final diagnosis of the cases.
Final diagnosis of the fifty cases was based on pathology results in biopsied cases (42 cases) and on clinical and ultrasound follow up in non-biopsied cases (8 cases) which resulted into total number of 31 malignant cases and 19 benign cases.
FA values in detected lesions ranged from 0.05 to 0.48 (mean 0.26 ± 0.096 SD), while ADC values ranged from 0.5 to 2.4 x10-3 mm2/sec (mean 1.21 ± 0.45 SD).