title: Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-a pilot study.
abstract: OBJECTIVE
  To investigate the tissue characteristics of cervical cancer based on the intravoxel incoherent motion (IVIM) model and to assess the IVIM parameters in tissue differentiation in the female pelvis.
  
  
  METHODS
  Sixteen treatment-naïve cervical cancer and 17 age-matched healthy subjects were prospectively recruited for diffusion-weighted (b = 0-1,000 s/mm(2)) and standard pelvic MRI. Bi-exponential analysis was performed to derive the perfusion parameters f (perfusion fraction) and D* (pseudodiffusion coefficient) as well as the diffusion parameter D (true molecular diffusion coefficient) in cervical cancer (n = 16), normal cervix (n = 17), myometrium (n = 33) and leiomyoma (n = 14). Apparent diffusion coefficient (ADC) was calculated. Kruskal-Wallis test and receiver operating characteristics (ROC) curves were used.
  
  
  RESULTS
  Cervical cancer had the lowest f (14.9 ± 2.6%) and was significantly different from normal cervix and leiomyoma (p < 0.05). The D (0.86 ± 0.16 x 10(-3) mm2/s) was lowest in cervical cancer and was significantly different from normal cervix and myometrium (p < 0.05) but not leiomyoma. No difference was observed in D*. D was consistently lower than ADC in all tissues. ROC curves indicated that f < 16.38%, D < 1.04 × 10(-3) mm(2)/s and ADC < 1.13 × 10(-3) mm(2)/s could differentiate cervical cancer from non-malignant tissues (AUC 0.773-0.908).
  
  
  CONCLUSIONS
  Cervical cancer has low perfusion and diffusion IVIM characteristics with promising potential for tissue differentiation.
  
  
  CONCLUSIONS
  • Diffusion-weighted MRI is increasingly applied in evaluation of cervical cancer. • Cervical cancer has distinctive perfusion and diffusion characteristics. • Intravoxel incoherent motion characteristics can differentiate cervical cancer from non-malignant uterine tissues.
authors.affiliation: Department of Diagnostic Radiology, Queen Mary Hospital, The University of Hong Kong, Room 406, Block K, 102 Pokfulam Road, Hong Kong, Hong Kong, eyplee77@hku.hk.
authors.forename: Elaine Yuen Phin
authors.initials: EY
authors.lastname: Lee
authors.forename: Xue
authors.initials: X
authors.lastname: Yu
authors.forename: Mandy Man Yee
authors.initials: MM
authors.lastname: Chu
authors.forename: Hextan Yuen Sheung
authors.initials: HY
authors.lastname: Ngan
authors.forename: Steven Wai Kwan
authors.initials: SW
authors.lastname: Siu
authors.forename: Inda Sung
authors.initials: IS
authors.lastname: Soong
authors.forename: Queenie
authors.initials: Q
authors.lastname: Chan
authors.forename: Pek-Lan
authors.initials: PL
authors.lastname: Khong
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
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