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Introduction: Breast edema can be caused by a variety of pathologic processes of benign or malignant diseases. Contrast enhanced digital mammogram (CEDM) has been shown to improve the probability of malignancy detection when compared with the conventional mammography alone. Patients and methods: This study was prospectively carried on 34 female patients with breast edema at the female imaging unit of the Radiology Department. The age range was 29-80 years. Bilateral conventional mammography (MX) and contrast-enhanced digital mammographic procedure (CEDM) were performed in approximately 7-10 min and followed by complementary ultrasound (US). Results: As regards enhancement patterns in our study, noncontrast uptake and diffuse parenchymal uptake were considered as benign and intense contrast uptake is considered malignant and ring enhancement in keeping with both benign and malignant lesions. The calculated sensitivity and specificity of dual energy contrast enhanced digital mammography were 95%, and 73% respectively, with a positive predictive value (PPV) of 88% and negative predictive value (NPV) of 88%. Conclusion: Dual-energy contrast-enhanced digital mammography is a useful technique in identification of lesions in mammographically dense edematous breasts and proved to be a useful tool in the follow-up of cases presenting by edema after conservative breast surgery and chemotherapy.

Background: Ovarian tumors are one of the prevalent gynecological tumors. They are the fifth commonest tumor in women. The therapeutic strategy depends on whether the tumor is benign, borderline or malignant. They always cause nonspecific symptoms at early stages and diagnosed at advanced stages. We tried to test and compare the sensitivity and accuracy of diffusion-weighted imaging (DWI) and MR perfusion in the diagnosis of ovarian tumors among fifty patients with ovarian masses who collected after meeting the inclusion criteria depending on grayscale sonographic findings after the approval of the ethical committee of our institution. The sensitivity and accuracy of the techniques were compared. Results: The surgical and pathological reports of our patients proved a non-tumorous lesion in three patients. They also proved benign ovarian tumors in 18/47 (38.3%) patients, borderline tumors in 4/47 (8.5%) patients and malignant ovarian tumors in 25/47 (53.2%) patients. According to conventional MRI, ovarian tumors could be diagnosed with sensitivity 92%, specificity 61.11%, PPV 76.7%, NPV 84.6% and accuracy 79.1%. DWI and MR perfusion showed the same results where they showed sensitivity 98%, specificity 83%, PPV 90%, NPV 98% and accuracy 93% with ADC cutoff value 1 × 10− 3 mm 2 /s. Conclusion: Diffusion-weighted imaging and MR perfusion are useful in the diagnosis of ovarian tumors with approximately the same sensitivity and positive impact on operative management.

Background The status of axillary nodes is a determining factor of management and prognosis for patients having a recent diagnosis of breast cancer. Axillary nodes are usually evaluated by ultrasonography (US) and biopsy, if indicated. Ultrasound-guided sampling and intraoperative or sentinel nodal sampling are available options, however, are invasive and hold risks of potential complications, calling for reliable, non-invasive axillary imaging. In the current prospective study, we assessed the performance of shear wave (SWE) and strain (SE) ultrasound elastography regarding preoperative axillary assessment. Sixty axillary nodes from 60 patients (age 28–65 years, mean 49.88 ± 7.61 SD) were included, all scoring BIRADS 4–5 on sonomammography. Results For US, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 100%, 66.67%, 84.78%, 100%, and 88.33%, respectively. Cortical thickness and vascularity were the most sensitive. For qualitative SWE, indices were 76.92%, 80.95%, 88.24%, 65.38% and 78.33%, respectively. Calculated cut-off for Emax was 59.3 and for Eratio was 4.56, giving statistical indices of 76.9%, 90.5%, 93.75%, 67.86%, and 81.67% for Emax and 76.9%, 100%, 100%, 70% and 85% respectively for Eratio. Both Emax and Eratio were greater for malignant (Emax 81.77 ± 1.904, Eratio 8.95 ± 5.69) than for benign nodes (Emax 37.59 ± 33.37, Eratio 2.5 ± 1.37) (P values < 0.001). For qualitative SE, sensitivity and specificity were 92.31% and 57.14%, while PPV, NPV, and accuracy were 80% each (P values < 0.001). The calculated cut-off value for SR was 3.85, giving indices of 87.2%, 76.2%, 76.19%, 87.18% and 83.33% respectively. Conclusion Adding elastography evaluation to conventional US positively impacts the specificity and accuracy of the preoperative axillary nodal status assessment in patients having newly diagnosed breast cancer.

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