title: Histogram analysis of apparent diffusion coefficient for the assessment of local aggressiveness of cervical cancer.
abstract: OBJECTIVE
  To retrospectively explore the value of apparent diffusion coefficient (ADC) histogram in assessing local aggressiveness of cervical cancer.
  
  
  METHODS
  53 patients with cervical cancer, including 7 cases at stage IB1, 17 cases at stage IB2 and 29 cases at stage IIA, were subjected to preoperative MRI including diffusion-weighted imaging with b values of 0 and 800 s/mm(2). The average of mean ADC values (ADCmean), minimum ADC values (ADCmin) and the 5th to 85th percentile ADC values every 10 % (ADC5 %, ADC15 %, ADC85 %) were measured. ADC values were compared between subgroups according to pathologic subtype, histological differentiation, depth of cervical infiltration, and lymph node metastases.
  
  
  RESULTS
  ADCmean and ADCmin for adenocarcinoma were 1,170.3 ± 97.8 × 10(-6) and 748.7 ± 157.5 × 10(-6) mm(2) s(-1), respectively, significantly higher than that of squamous cell carcinoma (SCC) (1,053.8 ± 134.3 × 10(-6) and 615.6 ± 170.2 × 10(-6) mm(2) s(-1), respectively). ADCmean and ADC5 %-ADC85 % of well or moderately tumor were significantly higher than poorly differentiated tumor, but ADCmin was not significantly different among different differentiated cervical cancer. Only ADC5 %-ADC45 % could discriminate well or moderately differentiated SCC from poorly differentiated SCC. ADC5 % for distinguishing well/moderately from poorly differentiated cervical cancer had a largest AUC (0.83). There was no statistical difference in ADC value for different depth of cervical infiltration or lymph node metastases.
  
  
  CONCLUSIONS
  ADC values are helpful in assessing pathologic subtype and the differentiation of cervical cancer.
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuai Fu Yuan #1, Beijing, 100730, China.
authors.forename: Huadan
authors.initials: H
authors.lastname: Xue
authors.forename: Cui
authors.initials: C
authors.lastname: Ren
authors.forename: Jiaxin
authors.initials: J
authors.lastname: Yang
authors.forename: Zhaoyong
authors.initials: Z
authors.lastname: Sun
authors.forename: Shuo
authors.initials: S
authors.lastname: Li
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Jin
authors.forename: Keng
authors.initials: K
authors.lastname: Shen
authors.forename: Weixun
authors.initials: W
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012372:ROC Curve; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*