Detection of lymph node metastasis in cervical and uterine cancers by diffusion-weighted magnetic resonance imaging at 3T.
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.
Lin
Gigin
G
Department of Radiology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 5 Fu Hsing Street, Kwei Shan Hsiang, Taoyuan, Taiwan.
Ho
Kung-Chu
KC
Wang
Jiun-Jie
JJ
Ng
Koon-Kwan
KK
Wai
Yau-Yau
YY
Chen
Yen-Ting
YT
Chang
Chee-Jen
CJ
Ng
Shu-Hang
SH
Lai
Chyong-Huey
CH
Yen
Tzu-Chen
TC
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