title: Evaluation of international federation of gynecology and obstetrics stage IB cervical cancer: comparison of diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging at 3.0 T.
abstract: OBJECTIVE
  The objective of this study was to compare the diagnostic performance of diffusion-weighted (DW) imaging with that of dynamic contrast-enhanced (DCE) imaging in the evaluation of tumor extent in patients with stage IB cervical cancer.
  
  
  METHODS
  This retrospective study was approved by the institutional review board. Between June 2010 and March 2012, 46 consecutive patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB who underwent preoperative DCE, DW (b = 0 and 800 s/mm), and T1- and T2-weighted imaging were included in this study. Two radiologists independently evaluated the extent of cervical cancer and made a diagnosis of tumor stage according to the revised FIGO staging system. The staging accuracy by DCE and DW for readers 1 and 2 was compared with the McNemar test, and κ statistics were used for reader agreement.
  
  
  RESULTS
  No statistical difference between the diagnostic performance of staging with DCE and with DW was observed in reader 1 (P = 1.000) or in reader 2 (P = 0.109). Interobserver agreement between the 2 readers for staging was both substantial with DCE (κ = 0.750, P < 0.001) and with DW (κ = 0.683, P < 0.001).
  
  
  CONCLUSIONS
  The diagnostic performance of DW in distinguishing the subdivision of stage IB cervical cancer was not statistically different from that of DCE. Diffusion-weighted imaging may be preferable to DCE for the preoperative evaluation of stage IB cervical cancer.
authors.affiliation: From the *Department of Medical Imaging, Fuzhou Medical College (Fuzhou General Hospital), Second Military Medical University, Fuzhou; and †Department of Medical Imaging, 174 Hospital of PLA, Xiamen, Fujian Province, China.
authors.forename: Yuning
authors.initials: Y
authors.lastname: Lin
authors.forename: Ziqian
authors.initials: Z
authors.lastname: Chen
authors.forename: Fei
authors.initials: F
authors.lastname: Kuang
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhong
authors.forename: Ming
authors.initials: M
authors.lastname: Ma
mesh_terms: D000328:Adult; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000473:pathology*
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA