title: Correlation of histogram analysis of apparent diffusion coefficient with uterine cervical pathologic finding.
abstract: OBJECTIVE
  The purpose of this study was to investigate the application of histogram analysis of apparent diffusion coefficient (ADC) in characterizing pathologic features of cervical cancer and benign cervical lesions.
  
  
  METHODS
  This prospective study was approved by the institutional review board, and written informed consent was obtained. Seventy-three patients with cervical cancer (33-69 years old; 35 patients with International Federation of Gynecology and Obstetrics stage IB cervical cancer) and 38 patients (38-61 years old) with normal cervix or cervical benign lesions (control group) were enrolled. All patients underwent 3-T diffusion-weighted imaging (DWI) with b values of 0 and 800 s/mm(2). ADC values of the entire tumor in the patient group and the whole cervix volume in the control group were assessed. Mean ADC, median ADC, 25th and 75th percentiles of ADC, skewness, and kurtosis were calculated. Histogram parameters were compared between different pathologic features, as well as between stage IB cervical cancer and control groups.
  
  
  RESULTS
  Mean ADC, median ADC, and 25th percentile of ADC were significantly higher for adenocarcinoma (p = 0.021, 0.006, and 0.004, respectively), and skewness was significantly higher for squamous cell carcinoma (p = 0.011). Median ADC was statistically significantly higher for well or moderately differentiated tumors (p = 0.044), and skewness was statistically significantly higher for poorly differentiated tumors (p = 0.004). No statistically significant difference of ADC histogram was observed between lymphovascular space invasion subgroups. All histogram parameters differed significantly between stage IB cervical cancer and control groups (p < 0.05).
  
  
  CONCLUSIONS
  Distribution of ADCs characterized by histogram analysis may help to distinguish early-stage cervical cancer from normal cervix or cervical benign lesions and may be useful for evaluating the different pathologic features of cervical cancer.
authors.affiliation: 1 Department of Medical Imaging, Fuzhou General Hospital, Second Military Medical University, No. 156, W Erhuan Rd, Fuzhou, 350025, Fujian, People's Republic of China.
authors.forename: Yuning
authors.initials: Y
authors.lastname: Lin
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.forename: Ziqian
authors.initials: Z
authors.lastname: Chen
authors.forename: Ping
authors.initials: P
authors.lastname: Ni
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhong
authors.forename: Huijuan
authors.initials: H
authors.lastname: Huang
authors.forename: Kumar
authors.initials: K
authors.lastname: Sandrasegaran
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008875:Middle Aged; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: apparent diffusion coefficient (ADC); cervical cancer; diffusion-weighted imaging (DWI); histogram