Huadan Xue MD, Presenter: Nothing to Disclose

Shuo Li MD, Abstract Co-Author: Nothing to Disclose

Fei Sun, Abstract Co-Author: Nothing to Disclose

Jin Zheng Yu, Abstract Co-Author: Nothing to Disclose

To evaluate the clinical value of MR whole body diffusion weighted imaging  for the diagnosis and preoperational staging of cervical cancer.

32 patients (mean 41.4 yrs old)proved to be cervical cancer by biopsy received pre-operational whole-body diffusion weighted image scan. Remote metastatic evaluation was made by PE, neck and post-peritoneum ultrasound, thorax/abdomen CT or abdomen/pelvic MR.Radiocal trachelectomy and pelvic lymphadenectomy were performed for patient without remote metastasis. Results of WB-DWI were compared with pathological findings. The Apparent Diffusion Coefficient value of normal cervical tissue and cervical cancer were compared. ADC value of normal or inflammatory lymph nodes was also compared with that of metastatic lymph nodes.Student t-test was used for statistical analysis.

There were 7 adenocarcinomas and 25 epitheliomas showed with biopsy results.26 patients received radiocal trachelectomy and pelvic lymphadenectomy except 6 with proved metastatic lesions.WBDWI showed 28 cervical lesions(87.5%), ADC value of normal cervical tissue, epithelioma and adenocarcinoma was1.75±0.26(32),0.89 ±0.20(21),1.07±0.15(7) respectively.T-test showed significant difference between normal cervical tissue and either tumor tissues(t=11.681 and 5.819, p<<0.01), While t-test between two tumor tissues showed a moderate significant p value (p=0.035, t=-2.225).For the ADC value of epithelioma, ROC curve showed that AUC=0.997 and max youden index(YI) can be achieved when ADC=1.255. In patients had lymphadenectomy (26), totally 82 lymph nodes including 16 metastatic ones were pathologically analyzed. DWI showed 76(92.7%) out of them.ADC value of normal/inflammatic and metastatic lymph nodes were 1.10±0.19 and 0.77±0.13, there was significant statistical difference in between (t=6.575, p<<0.01).ROC curve showed that AUC=0.965 and YImax can be achieved when ADC=0.921.DWI found 2 subclavical lymph nodes, 5 post-peritoneal lymph nodes and 1 hepatic metastasis, and all were proved by other imaging tools or biopsy.

In WB-DWI, cervical cancer and lymph metastasis could be clearly visualized and well differentiated from normal tissue.

WB-DWI is a promising imaging tool for cervical cancer pre-operational staging. ADC value could be useful in semi-quantitatively differentiating cervical cancer and lymph metastasis.

Xue, H, Li, S, Sun, F, Zheng Yu, J, Clinical Application of Whole Body Diffusion-weighted MR Imaging in the Diagnosis and Preoperational Staging of Cervical Cancer.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016981.html