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Diagnostic utility of apparent diffusion coefficient values in cervical cancer staging: A retrospective study
Peyman Kamali Hakim1,2, Fahimeh Zeinalkhani1,2, Soroush Alaeddini1,2
1Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran.
European Journal of Radiology Open
|April 20, 2026
Summary
Apparent diffusion coefficient (ADC) values accurately stage cervical cancer, correlating with disease progression and tumor spread. This imaging biomarker aids in treatment decisions, potentially optimizing therapy for patients.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Accurate cervical cancer staging is crucial for prognosis and treatment planning.
- Management strategies vary significantly between early and advanced stages.
- Diffusion-weighted imaging (DWI) offers potential for improved staging accuracy.
Purpose of the Study:
- To evaluate the diagnostic utility of apparent diffusion coefficient (ADC) values in staging cervical cancer.
- To assess the correlation between ADC values and clinicopathological features.
- To determine the role of ADC in identifying tumor extent and guiding therapeutic decisions.
Main Methods:
- Retrospective analysis of 146 cervical cancer patients who underwent pelvic MRI with DWI.
- Tumor staging performed according to FIGO classification by two independent radiologists.
- Spearman's rank correlation used to assess relationships between ADC values, age, stage, and tumor size.
- Diagnostic performance metrics (sensitivity, specificity, AUC) calculated for staging and involvement detection.
Main Results:
- Median ADC values significantly decreased with advancing disease stages (I-IV) (p<0.05).
- ADC values showed significant differences in patients with parametrial, vaginal, and lymph node involvement (p<0.05).
- ADC values demonstrated 82.1% sensitivity and 47.8% specificity for distinguishing tumors ≥4 cm; 85.0% sensitivity and 58.0% specificity for parametrial involvement; 68.8% sensitivity and 57.1% specificity for lymph node involvement.
Conclusions:
- Apparent diffusion coefficient (ADC) values show promise as a reliable tool for cervical cancer staging.
- ADC measurements can aid in clinical decision-making regarding therapy intensification or de-escalation.
- Integrating ADC into imaging protocols may enhance the accuracy of cervical cancer management.
