title: Contribution of diffusion-weighted imaging to diagnosis and staging of cervical cancer.
abstract: BACKGROUND
  Cervical cancer is the second most common female malignancy worldwide. Although its incidence has decreased in developed countries due to screening with Papanicolaou test, it is still the leading cause of cancer-related female death in developing countries.
  
  
  OBJECTIVE
  The aim of this study was to determine whether the apparent diffusion coefficient (ADC) measurements calculated from diffusion-weighted imaging (DWI) images had any contribution in differentiation of normal cervical tissue from malignant lesions preoperatively, and whether there was a correlation between the mean ADC values and tumor type, grade, or stage in malignant lesions.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Mean ADC values in 25 patients who had cervical cancer proved histopathologically, and 20 patients with otherwise normal uterus were compared. Also in the study group, mean ADC values were compared between histopathologic subtypes, tumor grades, and stages.
  
  
  RESULTS
  In the study group the mean ADC values (0.96±0.15×10(-3) mm(2)/s) were statistically lower than that of the control group (1.67±0.17×10(-3) mm(2)/s) (p<0.05). According to histopathologic sub-types there was no significant difference between mean ADC values of squamous cell cancer and adenocarcinoma (0.95×10(-3) mm(2)/s and 0.91×10(-3) mm(2)/s, respectively) (p>0.05). There was also no significant difference between the mean ADC values of the tumor grades (p>0.05). The mean ADC values in early stage cervical cancer (0.86±0.05×10(-3) mm(2)/s) were significantly lower than the mean ADC values in late stage disease (0.98±0.06×10(-3) mm(2)/s) (p<0.05).
  
  
  CONCLUSIONS
  ADC value measurements may provide useful information in diagnosis of cervical cancer as well as in preoperative assessment of the tumor stage.
authors.affiliation: Department of Radiology, Çarsamba District Hospital, Samsun, Turkey.
authors.forename: Tuna
authors.initials: T
authors.lastname: Demirbaş
authors.affiliation: Department of Radiology, Bakirkoy Training and Research Hospital, İstanbul, Turkey.
authors.forename: Tan
authors.initials: T
authors.lastname: Cimilli
authors.affiliation: Department of Radiology, Bakirkoy Training and Research Hospital, İstanbul, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Bayramoğlu
authors.affiliation: Department of Radiology, Bakirkoy Training and Research Hospital, İstanbul, Turkey.
authors.forename: Nurten Turan
authors.initials: NT
authors.lastname: Güner
authors.affiliation: Department of Radiology, Bakirkoy Training and Research Hospital, İstanbul, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Hocaoğlu
authors.affiliation: Department of Radiology, Bakirkoy Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Inci
keywords: Apparent diffusion coefficient; cervical cancer; cervix; magnetic resonance