ABSTRACT
Background: MRI examination is a useful modality for staging and evaluation of gynecologic malignancy. The diffusion-weighted MR imaging [DW-MRI or DWI] method has been introduced to cancer diagnostics, and has widened the diagnostic capabilities of MRI. Functional information from DWI and DCE-MRI can supplement morphologic information obtained with conventional cross-sectional imaging methods
Aim of the Work: The aim of the present study is to evaluate the role of MRI in the diagnosis and staging of uterine cervical cancer and to assess the value of apparent diffusion coefficient [ADC] in the studied individuals
Patients and Methods:This prospective study included twenty two patients with clinically suspected cervical cancer and twenty two apparently healthy women with normal MRI appearance of the cervix. It was conducted in El-Demerdash Hospital. The patients were referred from the Gynecology Department to the Radiology Department [Women's Imaging Unit] for further MRI assessment with DWIs. Ten patients were followed up after receiving chemo-radiotherapy
Results: There was a high statistical difference between cervical cancer patients [Before-treatment] and control group according to ADC Value. There was a high statistical difference between cervical cancer patients [post-treatment] and control group according to ADC Value. In addition, there was a high statistical difference between cervical cancer patients [pre-treatment] and [post-treatment] according to ADC Value. The comparative study between ADC values versus tumor size and between ADC values versus histopathological result [types and grading] of the tumor was statistically non-significant
Conclusion: DWI serves as a functional technique, which provides information about water mobility, tissue cellularity, and stability of membrane integrity that can discriminate cervical carcinoma from healthy tissue, and increasing the radiologist's confidence in image interpretation. Therefore, it implies a non-invasive technique, which can be used especially if contrast intake is avoided as in pregnancy. ADC values are reliable for differentiating cervical cancer from normal cervix with higher diagnostic accuracy when added to DWI interpretation
Recommendations: Further studies on a larger scale of patients are needed to confirm the results obtained by this work