title: Diagnostic accuracy of diffusion-weighted MRI for differentiation of cervical cancer and benign cervical lesions at 3.0T: Comparison with routine MRI and dynamic contrast-enhanced MRI.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of routine magnetic resonance imaging (MRI) (T1 WI and T2 WI), diffusion-weighted MRI (DWI), and DCE-MRI (dynamic contrast-enhanced MRI) at 3.0T for differentiation of cervical cancer and benign cervical lesions.
  
  
  METHODS
  A cohort of 75 cervical cancer patients, 26 cervical leiomyoma patients, 22 patients with cervical polyps consecutively underwent pelvic MRI scanning on a 3T MR unit. Two radiologists independently evaluated images at three imaging settings; routine MRI alone, DWI combined with routine MRI (DWI+routine MRI), and DCE-MRI. The apparent diffusion coefficients (ADCs) were calculated from b 0, 600 s/mm(2) and b 0, 1000 s/mm(2).
  
  
  RESULTS
  DWI+routine MRI was significantly better than routine MRI and obtained high accuracy (0.95); the diagnostic performance was not significantly different between DWI+routine MRI and DCE-MRI. Reader agreement was excellent for both DWI+routine MRI (κ, 0.90) and DCE-MRI (κ, 0.92). The ADCs of cervical cancer were significantly lower than those of benign cervical lesions at both ADC maps (P = 0.0001). The diagnostic accuracy was not different at both ADC maps (P = 0.375).
  
  
  CONCLUSIONS
  For differentiation of cervical cancer and benign cervical lesions, unenhanced MRI with combined diffusion-weighted and routine MRI (DWI+routine MRI) at 3T can provide accurate information and may be preferable to DCE.
authors.affiliation: Department of Medical Imaging, 174th Hospital of Chinese PLA, Xiamen, Fujian Province, P.R. China.
authors.forename: Fei
authors.initials: F
authors.lastname: Kuang
authors.affiliation: Department of Medical Imaging, 174th Hospital of Chinese PLA, Xiamen, Fujian Province, P.R. China.
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Department of Medical Imaging, 174th Hospital of Chinese PLA, Xiamen, Fujian Province, P.R. China.
authors.forename: Huili
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Pathematology, The 174th Hospital of Chinese PLA, Xiamen, Fujian Province, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Feng
mesh_terms: D000328:Adult; D000465:Algorithms; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D064847:Multimodal Imaging / Q000379:methods*; 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
keywords: benign cervical lesion; cervical cancer; diffusion-weighted MRI; dynamic contrast enhanced MRI; routine MRI