Contribution of diffusion-weighted imaging to diagnosis and staging of cervical cancer

Cervical cancer is the second most common female malignancy worldwide. Although its incidence has decreased in developed countries due to screening with Papanicolaou test, it is still the leading cause of cancer-related female death in developing countries.

The aim of this study was to determine whether the apparent diffusion coefficient (ADC) measurements calculated from diffusion-weighted imaging (DWI) images had any contribution in differentiation of normal cervical tissue from malignant lesions preoperatively, and whether there was a correlation between the mean ADC values and tumor type, grade, or stage in malignant lesions.

Case-control study.

Mean ADC values in 25 patients who had cervical cancer proved histopathologically, and 20 patients with otherwise normal uterus were compared. Also in the study group, mean ADC values were compared between histopathologic subtypes, tumor grades, and stages.

In the study group the mean ADC values (0.96±0.15×10(-3) mm(2)/s) were statistically lower than that of the control group (1.67±0.17×10(-3) mm(2)/s) (p<0.05). According to histopathologic sub-types there was no significant difference between mean ADC values of squamous cell cancer and adenocarcinoma (0.95×10(-3) mm(2)/s and 0.91×10(-3) mm(2)/s, respectively) (p>0.05). There was also no significant difference between the mean ADC values of the tumor grades (p>0.05). The mean ADC values in early stage cervical cancer (0.86±0.05×10(-3) mm(2)/s) were significantly lower than the mean ADC values in late stage disease (0.98±0.06×10(-3) mm(2)/s) (p<0.05).

ADC value measurements may provide useful information in diagnosis of cervical cancer as well as in preoperative assessment of the tumor stage.