Introduction: Diffusion weighted Imaging "DWI" is a specific modality to produce images of tissues weighted with the local microstructural characteristics of water diffusion. DWI can give information as regards cellularity of breast lesions and it can be used for distinguishing between benign and malignant breast lesions, differentiating surgical scar from recurrence and monitoring therapies in locally advanced breast cancer Aim of the work: To assess the diagnostic value of diffusion weighted imaging as an adjuvant to breast magnetic resonance imaging for detection and differentiation of suspicious breast lesions and correlation with histopathologic findings, available clinical data or follow up. Methods: The studied group included 50 female patients referred for MRI breast for workup of a suspicious clinical, mammographic, or sonographic abnormality. Diffusion weighted imaging (DWI) was added to the routine study. Results of the contrast enhanced bilateral breast MRI and DWI of the 50 patients were all reported and compared with the histo-pathological results of surgery or biopsy and with the results of follow up of lesions that were not surgically removed or biopsied. Results: there was a highly significant relation between DWI and histopathological/ Follow Up results with p value = 0.000. The sensitivity, specificity, positive and negative predictive values of DWI for characterization of suspicious breast lesions in patients included in the study, were 89.5%, 100%, 100%, and 93.94% respectively. Conclusion: DWI is a short unenhanced scan that can be inserted easily into standard clinical breast MRI protocols as a potential adjunct that can be added routinely to conventional breast MRI, and can accurately differentiate benign from malignant breast lesions with high sensitivity and specificity.

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Background Digital Breast Tomosythesis is a new technology of digital mammography that enables the acquisition of three dimensional volume of thin section data, and thus reduces or eliminates tissue overlap especially in dense breast, such ability allow visualization of cancers not apparent by digital mammography and differentiate between benign and malignant lesion. Objectives to compare the efficacy of digital breast Tomosynthesis (BDT) to digital Mammography (DM) in diagnosis of different breast lesions in dense breast. Patients and Method in this prospective study 30 patients with breast density ACR/C and ACR/D were assessed by Digital Mammography and Digital Breast Tomsynthesis. Each lesion was assigned a blinded category in an individual performance for each modality. The resultant BI-RADS categories were correlated with report of the pathology specimens or outcome follow up. Results Both modalities were compared regarding characterization, using Chi Square test (p value:0.035).The sensitivity, specificity and accuracy of digital mammography was 62.5%, 68.75% and 66% have significantly increase with tomosynthesis to be 100%,91% and 97% respectively. Conclusion Digital breast tomosythesis significantly enhanced characterization of breast lesions than digital mammography in dense breast parenchyma (ACR/C and ACR/D).

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