Diffusion-weighted MRI in cervical cancer

The purpose was to investigate the potential value of apparent diffusion coefficient (ADC) measurement with MRI in the assessment of cervix cancer. Diffusion-weighted MRI was performed in 47 patients with cervical carcinoma undergoing chemoradiation therapy and 26 normal controls on a 1.5-T system with a b-value of 600 s/mm(2). FIGO stage, tumor volume, nodal status, interstitial fluid pressure (IFP) and oxygen measurements were recorded. Response was defined as no visible tumor 3-6 months following completion of therapy. The average median ADC (mADC) of cervical carcinomas (1.09+/-0.20 x 10(-3) mm(2)/s) was significantly lower than normal cervix (2.09+/-0.46 x 10(-3) mm(2)/s) (P<0.001). There was no correlation between mADC, nodal status, tumor volume, IFP or oxygen measurements. mADC was significantly lower in FIGO stages T1b/T2a (0.986 x 10(-3) mm(2)/s) compared to T2b (1.21 x 10(-3) mm(2)/s) and T3/T4 (1.10 x 10(-3) mm(2)/s) (P<0.001). In patients with squamous carcinomas the 90th percentile of ADC values was lower in responders than non-responders (P<0.05). Median ADC in cervix carcinoma is significantly lower compared to normal cervix. ADC may have predictive value in squamous tumors, but further long-term study will determine the ultimate clinical utility.