title: The Value of Diffusion-Weighted Imaging in Predicting the Prognosis of Stage IB-IIA Cervical Squamous Cell Carcinoma After Radical Hysterectomy.
abstract: OBJECTIVE
  The aim of the study was to investigate the value of mean apparent diffusion coefficient (ADC(mean)) value in predicting the prognosis of stage IB-IIA cervical squamous cell carcinoma (SCC) patients after radical hysterectomy.
  
  
  METHODS
  A total of 126 patients who were with stage IB-IIA cervical SCC and underwent magnetic resonance imaging examination and radical hysterectomy were retrospectively investigated. Receiver operating characteristic curve was used to determine the cutoff values of ADC(mean) for predicting earlier recurrence (2 consecutive increases in the SCC antigen value of more than 1 ng/mL or elevation of greater than 1.5 ng/mL). Disease-free survival and overall survival were analyzed using the Kaplan-Meier method, and differences between the survival curves were examined using the log-rank test.
  
  
  RESULTS
  Earlier recurrence was observed in 46 patients (36.2%) during a median follow-up of 22 months. The ADC(mean) value (P = 0.005), parametrial invasion (P = 0.049), and lymphovascular space invasion (P = 0.037) were significantly associated with earlier recurrence. Receiver operating characteristic curve identified that the cutoff value of ADC(mean) for predicting earlier recurrence was 0.785 × 10(-3)mm(2)/s. The ADC(mean) value, parametrial invasion, and lymphovascular space invasion were significantly associated with earlier recurrence. The hazard ratios were 7.33 (95% confidence interval [95% CI], 1.854-28.99), 4.88 (95% CI, 1.00-23.73), and 2.53 (95% CI, 1.058-6.052), respectively. Disease-free survival and overall survival rates of patients with the ADC(mean) less than 0.785 × 10(-3)mm(2)//s were significantly worse than those of patients with the ADC(mean) greater than or equal to 0.785 × 10(-3)mm(2)/s.
  
  
  CONCLUSIONS
  Mean ADC was a good biomarker in predicting the prognosis of stage IB-IIA cervical SCC after radical hysterectomy.
authors.affiliation: *Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai; and †Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Guoxing
authors.initials: G
authors.lastname: Zhou
authors.forename: Xiao
authors.initials: X
authors.lastname: Chen
authors.forename: Fei
authors.initials: F
authors.lastname: Tang
authors.forename: Jie
authors.initials: J
authors.lastname: Zhou
authors.forename: Yibin
authors.initials: Y
authors.lastname: Wang
authors.forename: Zhongqiu
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery