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European Radiology
Published in: European Radiology 7/2014

01-07-2014 | Urogenital

Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-a pilot study

Authors: Elaine Yuen Phin Lee, Xue Yu, Mandy Man Yee Chu, Hextan Yuen Sheung Ngan, Steven Wai Kwan Siu, Inda Sung Soong, Queenie Chan, Pek-Lan Khong

Published in: European Radiology | Issue 7/2014

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Abstract

Objectives

To investigate the tissue characteristics of cervical cancer based on the intravoxel incoherent motion (IVIM) model and to assess the IVIM parameters in tissue differentiation in the female pelvis.

Methods

Sixteen treatment-naïve cervical cancer and 17 age-matched healthy subjects were prospectively recruited for diffusion-weighted (b = 0–1,000 s/mm2) and standard pelvic MRI. Bi-exponential analysis was performed to derive the perfusion parameters f (perfusion fraction) and D* (pseudodiffusion coefficient) as well as the diffusion parameter D (true molecular diffusion coefficient) in cervical cancer (n = 16), normal cervix (n = 17), myometrium (n = 33) and leiomyoma (n = 14). Apparent diffusion coefficient (ADC) was calculated. Kruskal–Wallis test and receiver operating characteristics (ROC) curves were used.

Results

Cervical cancer had the lowest f (14.9 ± 2.6 %) and was significantly different from normal cervix and leiomyoma (p < 0.05). The D (0.86 ± 0.16 x 10-3 mm2/s) was lowest in cervical cancer and was significantly different from normal cervix and myometrium (p < 0.05) but not leiomyoma. No difference was observed in D*. D was consistently lower than ADC in all tissues. ROC curves indicated that f < 16.38 %, D < 1.04 × 10-3 mm2/s and ADC < 1.13 × 10-3 mm2/s could differentiate cervical cancer from non-malignant tissues (AUC 0.773–0.908).

Conclusions

Cervical cancer has low perfusion and diffusion IVIM characteristics with promising potential for tissue differentiation.

Key Points

• Diffusion-weighted MRI is increasingly applied in evaluation of cervical cancer.
• Cervical cancer has distinctive perfusion and diffusion characteristics.
• Intravoxel incoherent motion characteristics can differentiate cervical cancer from non-malignant uterine tissues.
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Metadata
Title
Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-a pilot study
Authors
Elaine Yuen Phin Lee
Xue Yu
Mandy Man Yee Chu
Hextan Yuen Sheung Ngan
Steven Wai Kwan Siu
Inda Sung Soong
Queenie Chan
Pek-Lan Khong
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3160-7

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