الفهرس 
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Abstract
One of the most common cancers in women is breast cancer, which is acknowledged by everyone. Finding early indicators and appropriate predictors that account for the features of the disease has remained a constant issue in encouraging women to actively check their breast health.
There are 28,000 confirmed occurrences of breast cancer per year in Egypt, according to the National Cancer Institute (NCI). This makes it the most common disease in females.
Our goal is to continuously maximize the use of various breast cancer detection methods.
Magnetic resonance imaging (MRI) is a vital tool for breast examination for a variety of reasons, including but not limited to: detecting recurrence, evaluating breast implants, screening high-risk individuals, evaluating cancers of unknown origin, resolving ambiguous findings on mammography and sonography, and determining the stage before surgery.
The field of breast MRI has undergone a significant revolution due to the application of new technologies like MR DWI and spectroscopy. Both methods are being utilized to evaluate the biological activity of breast lesions without injecting contrast material, despite their divergent conceptual bases.
Our study’s overarching goal was to determine how well DWI, when combined with traditional imaging techniques and without contrast injection, can identify and evaluate various breast lesions. Reclassifying breast lesions with high BIRADS ratings and reducing the frequency of unnecessary biopsies were the goals.
Thirty female patients with sono-mammography-detected ambiguous breast tumors were included in the study. A 1.5 tesla MRI machine was used to conduct the scans on the patients. Between July 2022 and September 2023, participants participated in the study at the radiology departments of El Minya University Hospital and Minya Oncology Centre.
Based on our research, the best value for the threshold to detect cancer is 0.9 x 10 -3 mm2/sec. Regardless of the use of mammography, our results show that diffusion-weighted imaging (DWI) outperformed sonography in terms of sensitivity and specificity.
We found a sensitivity of 77.8% and a specificity of 94% for the DWI images without contrast. Using conventional imaging methods in DWI MRI, contrast injection was unnecessary in downgrading 20 out of 30 cases.
Overall, the study found that CE-MRI was very sensitive (93% sensitivity) and specific (97%) when used independently.
We found that a sensitivity rate of 92% and a specificity rating of 88.9% were achieved when CE-MRI was used in conjunction with DWI.
Without administering contrast, we were able to downgrade 18 out of 30 patients using DWI MRI alone.
Considering this, DWI MRI has demonstrated potential in distinguishing between benign and malignant tumors.
Conclusion
CEMRI is undeniably efficient in detecting and discriminating indeterminate breast lesions especially when combined with DWI. Yet, with the high cost of the contrast and in case of contrast contraindications, or unavailability. DWI has proven to be an effective diagnostic tool and a reasonable substitute for CE-MRI that aids in downgrading the breast lesion BIRADS with relative decrease in the unneeded biopsies.