Staging of uterine cervical carcinoma: whole-body diffusion-weighted magnetic resonance imaging

To evaluate the clinical value of magnetic resonance whole-body diffusion-weighted imaging (WB-DWI) in the staging of uterine cervical carcinoma.

Twenty-six patients with untreated uterine cervical carcinoma received preoperative conventional MR and WB-DWI scans. WB-DWI scans were also obtained in 30 healthy volunteers. Measurements of apparent diffusion coefficient (ADC) were made on scans of normal uterine cervix and uterine cervical carcinoma, and benign and metastatic lymph nodes. Statistical analysis was applied to the obtained data.

Mean ADC value of uterine cervical carcinoma was significantly lower than the 3 layers of normal uterine cervix (P = 0.00). When an ADC value of 1.28 × 10(-3) mm(2)/s is used as the threshold, its sensitivity is 96%, specificity is 100%, and accuracy is 98%. Mean ADC value of metastatic nodes [(0.96 ± 0.14) × 10(-3) mm(2)/s] was significantly lower than that of benign nodes [(1.39 ± 0.19) × 10(-3) mm(2)/s] (t = 9.93, P = 0.00). When an ADC value of 1.14 × 10(-3) mm(2)/s is used as the threshold, its sensitivity is 83%, specificity is 98%, and accuracy is 94%.

WB-DWI scan is capable of distinguishing uterine cervical carcinoma from normal uterine cervix, and is capable of separating metastatic nodes from benign nodes.