The value of apparent diffusion coefficient in the assessment of cervical cancer

• Published in: European radiology Vol. 23; no. 4; pp. 1050 - 1058
• Main Authors: Kuang, Fei, Ren, Jing, Zhong, Qun, Liyuan, Fu, Huan, Yi, Chen, Ziqian
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.04.2013; Springer Nature B.V
• Subjects: Adult; Aged; Algorithms; Cervical cancer; Diagnostic Radiology; Diffusion Magnetic Resonance Imaging - methods; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging; Internal Medicine; Interventional Radiology; Magnetic Resonance; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Radiology; Reproducibility of Results; Sensitivity and Specificity; Ultrasound; Uterine Cervical Neoplasms - pathology; Diffusion-weighted imaging; MRI; Cervical cancer; Assessment; Apparent diffusion coefficient
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-012-2681-1

Objectives To evaluate the potential value of apparent diffusion coefficient (ADC) measurement in the assessment of cervical cancer. Methods One hundred twelve patients with cervical cancer and 67 control subjects underwent diffusion-weighted imaging (DWI) in addition to routine MR imaging at 3.0-T MRI before therapy. All ADCs were calculated from b  = 0, 600 s/mm 2 and b  = 0, 1,000 s/mm 2 . Results The ADCs of cervical cancer were significantly lower than those of normal cervix for both ADC maps. There was a statistically significant difference between the ADCs of well-/moderately differentiated (G1/2) tumours and poorly differentiated (G3) tumours, between the ADCs of squamous cell carcinoma and adenocarcinoma, between the pretherapy ADCs of tumour recurrence or metastasis and tumour free patients after radical hysterectomy for both ADC maps. There was no significant difference among the ADCs of cervical cancer when divided by other features (FIGO, lymph node status, tumour size and age groups) for both ADC maps. Conclusion ADC values were reliable for differentiating cervical cancer from normal cervix with high diagnostic accuracy. The ADCs can be used to indicate the degree and histological type of cervical cancer, although there is some overlap. G3 tumours and lower ADCs may indicate poor prognosis. The diagnostic accuracy was equal for both ADC maps. Key Points • Diffusion-weighted magnetic resonance imaging provides new information about cervical cancer • Apparent diffusion coefficient values can differentiate cervical cancer from normal cervical tissue • Pretherapy ADCs can also predict the prognosis for patients who have undergone radical hysterectomy • ADCs can help indicate the degree and histological type of cervical cancer • Patients with G3 tumours and lower ADCs may benefit from preoperative chemoradiation