title: Detection of lymph node metastasis in cervical and uterine cancers by diffusion-weighted magnetic resonance imaging at 3T.
abstract: OBJECTIVE
  To evaluate diffusion-weighted imaging (DWI) for detection of pelvic lymph node metastasis in patients with cervical and uterine cancers.
  
  
  METHODS
  Fifty patients scheduled for pelvic lymph node dissection were enrolled for 3T magnetic resonance imaging (MRI) using a single-shot echo-planar DWI technique, body-phased array coil, b = 0, 1000 s/mm(2). We measured short/long-axis diameters, mean apparent diffusion coefficient (ADC) values of all identifiable nodes, relative ADC values between tumors and nodes, and utilized their cutoff values to validate the diagnostic accuracy internally. Histopathologic results served as the reference standard.
  
  
  RESULTS
  The relative ADC values between tumor and nodes were significantly lower in metastatic than in benign nodes (0.06 vs. 0.21 x 10(-3) mm(2)/s, P < 0.001; cutoff value 0.10 x 10(-3) mm(2)/s). Compared to conventional MRI, the method combining size and relative ADC values resulted in better sensitivity (25% vs. 83%) and similar specificity (98% vs. 99%). The smallest metastatic lymph node detected by this method measured 5 mm on its short axis.
  
  
  CONCLUSIONS
  The combination of size and relative ADC values was useful in detecting pelvic lymph node metastasis in patients with cervical and uterine cancers.
authors.affiliation: Department of Radiology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 5 Fu Hsing Street, Kwei Shan Hsiang, Taoyuan, Taiwan.
authors.forename: Gigin
authors.initials: G
authors.lastname: Lin
authors.forename: Kung-Chu
authors.initials: KC
authors.lastname: Ho
authors.forename: Jiun-Jie
authors.initials: JJ
authors.lastname: Wang
authors.forename: Koon-Kwan
authors.initials: KK
authors.lastname: Ng
authors.forename: Yau-Yau
authors.initials: YY
authors.lastname: Wai
authors.forename: Yen-Ting
authors.initials: YT
authors.lastname: Chen
authors.forename: Chee-Jen
authors.initials: CJ
authors.lastname: Chang
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology