title: Minimum apparent diffusion coefficient for predicting lymphovascular invasion in invasive cervical cancer.
abstract: To investigate the diagnostic performance of minimum apparent diffusion coefficient (mini-ADC) for predicting lymphovascular invasion (LVI) in invasive cervical cancer.
  
  
  
  Ninety-six patients with pathologically confirmed invasive cervical cancer (CC) underwent conventional preoperative magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) on a 3.0T MRI system. Tumor ADC, mini-ADC and mini-ADC ratio (mini-ADC value / tumor ADC value) were obtained and compared between LVI-positive and LVI-negative invasive CC, and correlation between LVI status and Ki-67, p16, p63, and clinical prognostic factors were analyzed. ADC thresholds and diagnostic performance were determined by receiver operating characteristic (ROC) analysis.
  
  
  
  Tumor ADC showed no significant difference (P = 0.300) between LVI-positive invasive CC (n = 27) and LVI-negative invasive CC (n = 69); the mini-ADC and mini-ADC ratio were significantly lower in LVI-positive invasive CC than in LVI-negative invasive CC ([0.712 ± 0.078 × 10-3mm2/s] vs. [0.867 ± 0.099 × 10-3mm2/s], P < 0.001; and [0.772 ± 0.062] vs. [0.917 ± 0.052], P < 0.001, respectively). ROC curve analysis yielded a cutoff mini-ADC value of 0.837 in the differentiation of LVI-positive and LVI-negative invasive CC, with a sensitivity of 65%, specificity of 100%, and area under the curve (AUC) of 0.885; a cutoff mini-ADC ratio of 0.875 with a sensitivity of 78%, specificity of 100%, AUC of 0.970, positive predictive value of 100%, and negative predictive value of 64%. There was a positive correlation between LVI status and Ki-67 (r = 0.241, P = 0.014) and a negative correlation between mini-ADC and LVI status (r = -0.582, P < 0.001); mini-ADC and Ki-67 (r = -0.587, P < 0.001).
  
  
  
  Mini-ADC value appears to be a simple and effective tool for the prediction of LVI status in invasive CC, and the mini-ADC ratio may be the best parameter in discriminating between LVI-positive and LVI-negative invasive CC.
  
  
  
  1 Technical Efficacy: Stage 4 J. MAGN. RESON. IMAGING 2017;45:1771-1779.
authors.affiliation: Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, P.R. China.|Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, P.R. China.
authors.forename: Jin Wei
authors.initials: JW
authors.lastname: Qiang
authors.affiliation: Department of Pathology, General Hospital of Ningxia Medical University, 804 Shengli Road, Yinchuan, 750004, China.
authors.forename: Hai Ping
authors.initials: HP
authors.lastname: Tian
authors.affiliation: Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, P.R. China.
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, P.R. China.
authors.forename: Ai Jun
authors.initials: AJ
authors.lastname: Wang
authors.affiliation: Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, P.R. China.
authors.forename: Jian Guo
authors.initials: JG
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D020738:Leptin; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D020738:Leptin
keywords: Ki-67; apparent diffusion coefficient; diffusion-weighted imaging; invasive cervical cancer; lymphatic vessels; magnetic resonance imaging