title: Diffusion-weighted MRI in cervical cancer.
abstract: The purpose was to investigate the potential value of apparent diffusion coefficient (ADC) measurement with MRI in the assessment of cervix cancer. Diffusion-weighted MRI was performed in 47 patients with cervical carcinoma undergoing chemoradiation therapy and 26 normal controls on a 1.5-T system with a b-value of 600 s/mm(2). FIGO stage, tumor volume, nodal status, interstitial fluid pressure (IFP) and oxygen measurements were recorded. Response was defined as no visible tumor 3-6 months following completion of therapy. The average median ADC (mADC) of cervical carcinomas (1.09+/-0.20 x 10(-3) mm(2)/s) was significantly lower than normal cervix (2.09+/-0.46 x 10(-3) mm(2)/s) (P<0.001). There was no correlation between mADC, nodal status, tumor volume, IFP or oxygen measurements. mADC was significantly lower in FIGO stages T1b/T2a (0.986 x 10(-3) mm(2)/s) compared to T2b (1.21 x 10(-3) mm(2)/s) and T3/T4 (1.10 x 10(-3) mm(2)/s) (P<0.001). In patients with squamous carcinomas the 90th percentile of ADC values was lower in responders than non-responders (P<0.05). Median ADC in cervix carcinoma is significantly lower compared to normal cervix. ADC may have predictive value in squamous tumors, but further long-term study will determine the ultimate clinical utility.
authors.affiliation: Department of Medical Imaging, University of Toronto, University Health Network, Princess Margaret Hospital, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
authors.forename: Patrick Z
authors.initials: PZ
authors.lastname: McVeigh
authors.forename: Aejaz M
authors.initials: AM
authors.lastname: Syed
authors.forename: Michael
authors.initials: M
authors.lastname: Milosevic
authors.forename: Anthony
authors.initials: A
authors.lastname: Fyles
authors.forename: Masoom A
authors.initials: MA
authors.lastname: Haider
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D018709:Statistics, Nonparametric; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy