Diagnostic value of lymph node metastasis by diffusion-weighted magnetic resonance imaging in cervical cancer

Diffusion.weighted imaging. (DWI) combined with its apparent diffusion coefficient. (ADC) value shows great significance in the differential diagnosis of human tumors. This meta.analysis is to determine whether ADC valued in DWI could contribute to the differential diagnosis of positive and negative lymph node. (LN) metastasis in cervical cancer. (CC) or not.

A series of types of computerized databases were used searching for eligible studies relied on a strict inclusion and exclusion criteria. Two investigators were involved in the process of selecting articles and extracting dataset. Standardized mean differences (SMD) for the assessment of ADC values in positive and negative LN metastasis in CC patients were calculated.

Fifteen cohort studies composed of 687 cases diagnosed with cervical tumor were incorporated into the current meta-analysis. Statistical analysis showed that the ADC value in positive LN metastasis was significantly lower than that with negative LN metastasis [SMD = 1.02, 95% confidence interval (CI) =0.54~1.50, P < 0.001]. Stratified by country, a lower ADC value in tumor tissues with LN metastasis was detected in comparison to that of tumor tissues without LN metastasis among China (SMD = 1.28, 95# CI = 0.62~1.94, P < 0.001) and Korea subgroups (SMD = 1.09, 95% CI = 0.65~1.52, P < 0.001).

The ADC values in CC tissues with LN metastasis were significantly lower than those without LN metastasis, suggesting that DWI appears to improve diagnostic performance and can be a useful adjunct imaging for identifying LN metastasis in CC patients.