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Published in: European Radiology 4/2013

01-04-2013 | Magnetic Resonance

The value of apparent diffusion coefficient in the assessment of cervical cancer

Authors: Fei Kuang, Jing Ren, Qun Zhong, Fu Liyuan, Yi Huan, Ziqian Chen

Published in: European Radiology | Issue 4/2013

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Abstract

Objectives

To evaluate the potential value of apparent diffusion coefficient (ADC) measurement in the assessment of cervical cancer.

Methods

One hundred twelve patients with cervical cancer and 67 control subjects underwent diffusion-weighted imaging (DWI) in addition to routine MR imaging at 3.0-T MRI before therapy. All ADCs were calculated from b = 0, 600 s/mm2 and b = 0, 1,000 s/mm2.

Results

The ADCs of cervical cancer were significantly lower than those of normal cervix for both ADC maps. There was a statistically significant difference between the ADCs of well-/moderately differentiated (G1/2) tumours and poorly differentiated (G3) tumours, between the ADCs of squamous cell carcinoma and adenocarcinoma, between the pretherapy ADCs of tumour recurrence or metastasis and tumour free patients after radical hysterectomy for both ADC maps. There was no significant difference among the ADCs of cervical cancer when divided by other features (FIGO, lymph node status, tumour size and age groups) for both ADC maps.

Conclusion

ADC values were reliable for differentiating cervical cancer from normal cervix with high diagnostic accuracy. The ADCs can be used to indicate the degree and histological type of cervical cancer, although there is some overlap. G3 tumours and lower ADCs may indicate poor prognosis. The diagnostic accuracy was equal for both ADC maps.

Key Points

Diffusion-weighted magnetic resonance imaging provides new information about cervical cancer
Apparent diffusion coefficient values can differentiate cervical cancer from normal cervical tissue
Pretherapy ADCs can also predict the prognosis for patients who have undergone radical hysterectomy
ADCs can help indicate the degree and histological type of cervical cancer
Patients with G3 tumours and lower ADCs may benefit from preoperative chemoradiation
Literature
1.
go back to reference Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125PubMed Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125PubMed
2.
go back to reference Wang J, Takashima S, Takayama F et al (2001) Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 220:621–630PubMedCrossRef Wang J, Takashima S, Takayama F et al (2001) Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 220:621–630PubMedCrossRef
3.
go back to reference Sala E, Rockall A, Rangarajan D, Kubik-Huch RA (2010) The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis. Eur J Radiol 76:367–385PubMedCrossRef Sala E, Rockall A, Rangarajan D, Kubik-Huch RA (2010) The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis. Eur J Radiol 76:367–385PubMedCrossRef
4.
go back to reference Punwani S (2011) Diffusion weighted imaging of female pelvic cancers: concepts and clinical applications. Eur J Radiol 78:21–29PubMedCrossRef Punwani S (2011) Diffusion weighted imaging of female pelvic cancers: concepts and clinical applications. Eur J Radiol 78:21–29PubMedCrossRef
5.
go back to reference Kim HS, Kim SY (2007) A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas. Am J Neuroradiol 28:1693–1699PubMedCrossRef Kim HS, Kim SY (2007) A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas. Am J Neuroradiol 28:1693–1699PubMedCrossRef
6.
go back to reference Higano S, Yun X, Kumabe T et al (2006) Malignant astrocytic tumours: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology 241:839–846PubMedCrossRef Higano S, Yun X, Kumabe T et al (2006) Malignant astrocytic tumours: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology 241:839–846PubMedCrossRef
7.
go back to reference Zhang J, Tehrani YM, Wang L, Ishill NM, Schwartz LH, Hricak H (2008) Renal masses: characterization with diffusion-weighted MR imaging—a preliminary experience. Radiology 247:458–464PubMedCrossRef Zhang J, Tehrani YM, Wang L, Ishill NM, Schwartz LH, Hricak H (2008) Renal masses: characterization with diffusion-weighted MR imaging—a preliminary experience. Radiology 247:458–464PubMedCrossRef
8.
go back to reference Hoogendam JP, Klerkx WM, de Kort GA et al (2010) The influence of the b-value combination on apparent diffusion coefficient based differentiation between malignant and benign tissue in cervical cancer. J Magn Reson Imaging 32:376–382PubMedCrossRef Hoogendam JP, Klerkx WM, de Kort GA et al (2010) The influence of the b-value combination on apparent diffusion coefficient based differentiation between malignant and benign tissue in cervical cancer. J Magn Reson Imaging 32:376–382PubMedCrossRef
9.
go back to reference Koh DM, Takahara T, Imai Y, Collins DJ (2007) Practical aspects of assessing tumours using clinical diffusion-weighted imaging in the body. Magn Reson Med Sci 6:211–224PubMedCrossRef Koh DM, Takahara T, Imai Y, Collins DJ (2007) Practical aspects of assessing tumours using clinical diffusion-weighted imaging in the body. Magn Reson Med Sci 6:211–224PubMedCrossRef
10.
go back to reference Charles-Edwards E, Morgan V, Attygalle AD et al (2011) Endovaginal magnetic resonance imaging of stage 1A/1B cervical cancer with A T2- and diffusion-weighted magnetic resonance technique: effect of lesion size and previous cone biopsy on tumour detectability. Gynecol Oncol 120:368–373PubMedCrossRef Charles-Edwards E, Morgan V, Attygalle AD et al (2011) Endovaginal magnetic resonance imaging of stage 1A/1B cervical cancer with A T2- and diffusion-weighted magnetic resonance technique: effect of lesion size and previous cone biopsy on tumour detectability. Gynecol Oncol 120:368–373PubMedCrossRef
11.
go back to reference Payne GS, Schmidt M, Morgan VA et al (2010) Evaluation of magnetic resonance diffusion and spectroscopy measurements as predictive biomarkers in stage 1 cervical cancer. Gynecol Oncol 116:246–252PubMedCrossRef Payne GS, Schmidt M, Morgan VA et al (2010) Evaluation of magnetic resonance diffusion and spectroscopy measurements as predictive biomarkers in stage 1 cervical cancer. Gynecol Oncol 116:246–252PubMedCrossRef
12.
go back to reference Chen J, Zhang Y, Liang B, Yang Z (2010) The utility of diffusion-weighted MR imaging in cervical cancer. Eur J Radiol 74:101–106CrossRef Chen J, Zhang Y, Liang B, Yang Z (2010) The utility of diffusion-weighted MR imaging in cervical cancer. Eur J Radiol 74:101–106CrossRef
13.
go back to reference Liu Y, Bai R, Sun H, Liu H, Wang D (2009) Diffusion-weighted magnetic resonance imaging of uterine cervical cancer. J Comput Assist Tomogr 33:858–862PubMedCrossRef Liu Y, Bai R, Sun H, Liu H, Wang D (2009) Diffusion-weighted magnetic resonance imaging of uterine cervical cancer. J Comput Assist Tomogr 33:858–862PubMedCrossRef
14.
go back to reference Kilickesmez O, Bayramoglu S, Inci E, Cimilli T, Kayhan A (2009) Quantitative diffusion-weighted magnetic resonance imaging of normal and diseased uterine zones. Acta Radiol 50:340–347PubMedCrossRef Kilickesmez O, Bayramoglu S, Inci E, Cimilli T, Kayhan A (2009) Quantitative diffusion-weighted magnetic resonance imaging of normal and diseased uterine zones. Acta Radiol 50:340–347PubMedCrossRef
15.
go back to reference McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA (2008) Diffusion-weighted MRI in cervical cancer. Eur Radiol 18:1058–1064PubMedCrossRef McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA (2008) Diffusion-weighted MRI in cervical cancer. Eur Radiol 18:1058–1064PubMedCrossRef
16.
go back to reference Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O (2005) Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol 15:71–78PubMedCrossRef Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O (2005) Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol 15:71–78PubMedCrossRef
17.
go back to reference Bilimoria KY, Bentrem DJ, Rock CE, Stewart AK, Ko CY, Halverson A (2009) Outcomes and prognostic factors for squamous-cell carcinoma of the anal canal: analysis of patients from the National Cancer Data Base. Dis Colon Rectum 52:624–631PubMedCrossRef Bilimoria KY, Bentrem DJ, Rock CE, Stewart AK, Ko CY, Halverson A (2009) Outcomes and prognostic factors for squamous-cell carcinoma of the anal canal: analysis of patients from the National Cancer Data Base. Dis Colon Rectum 52:624–631PubMedCrossRef
18.
go back to reference Hong JH, Tsai CS, Wang CC et al (2000) Comparison of clinical behaviors and responses to radiation between squamous cell carcinomas and adenocarcinomas/adenosquamous carcinomas of the cervix. Chang Gung Med J 23:396–404PubMed Hong JH, Tsai CS, Wang CC et al (2000) Comparison of clinical behaviors and responses to radiation between squamous cell carcinomas and adenocarcinomas/adenosquamous carcinomas of the cervix. Chang Gung Med J 23:396–404PubMed
19.
go back to reference Heatley MK (1999) Systematic review and meta-analysis in anatomic pathology: the value of nuclear DNA content in predicting progression in low grade CIN, the significance of the histological subtype on prognosis in cervical carcinoma. Histol Histopathol 14:203–215PubMed Heatley MK (1999) Systematic review and meta-analysis in anatomic pathology: the value of nuclear DNA content in predicting progression in low grade CIN, the significance of the histological subtype on prognosis in cervical carcinoma. Histol Histopathol 14:203–215PubMed
Metadata
Title
The value of apparent diffusion coefficient in the assessment of cervical cancer
Authors
Fei Kuang
Jing Ren
Qun Zhong
Fu Liyuan
Yi Huan
Ziqian Chen
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 4/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2681-1

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