Impact of diffusion weighted magnetic resonance imaging in diagnosis of cervical cancer

Abstract

Background

Cervical cancer is a widespread cancer among women worldwide. In this study, we evaluated the role of diffusion weighted magnetic resonance imaging (DWI-MRI) in diagnosis of cervical carcinoma with pathological diagnosis taken as the reference. The study included 70 patients in whom cancer cervix had been suspected clinically or by transvaginal U/S and confirmed by biopsy. The control group consisted of 40 patients with a normal cervix who performed MRI for other pelvic disorders. Pelvic MR with DWI and dynamic contrast enhanced MRI (DCE-MR) were done for all patients.

Results

Both DW-MRI and DCE-MRI revealed the same sensitivity, specificity, PPV, and accuracy; 100%, 50%, 97%, and 97%, respectively. The mean ADC value for malignant lesions was (0.82 × 10⁻³ ± 0.1 SD mm²/s). While the mean ADC value in the control group is (1.56 × 10^–3 mm²/s). ADC value of (1.07 × 10⁻³ mm²/s) is a cut-off between normal cervical tissue& malignant cervical lesion with a sensitivity 97% and specificity 95.5%

Conclusion

Each of the (DW-MRI) and (DCE-MRI) sequences when added to the non-contrast MRI sequences in the estimation of cancer cervix had elicited the same sensitivity, specificity, and accuracy. DW–MRI was significantly beneficial in terms of diagnostic performance. For patients who cannot receive contrast medium, dynamic contrast-enhanced imaging can be replaced by DWI. The ADC value in case of cervical cancer was significantly lower than in the non-affected cervical tissue.