Gui Benedetta, Russo Luca, Minordi Laura, Miccò Maura, Persiani Salvatore, Avesani Giacomo, Rufini Vittoria, Fuoco Valentina, Autorino Rosa, Ferrandina Gabriella, Scambia Giovanni, Manfredi Riccardo
Radiology Unit, Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Department of Radiological and Hematological Sciences, Catholic University of Sacred Heart, Rome, Italy.
Pol J Radiol. 2022 Aug 10;87:e438-e447. doi: 10.5114/pjr.2022.118914. eCollection 2022.
To evaluate the role of apparent diffusion coefficient (ADC) value measurement in the diagnosis of meta-static lymph nodes (LNs) in patients with locally advanced cervical cancer (LACC) and to present a systematic review of the literature.
Magnetic resonance imaging (MRI) exams of patients with LACC were retrospectively eva-luated. Mean ADC, relative ADC (rADC), and correct ADC (cADC) values of enlarged LNs were measured and compared between positron emission tomography (PET)-positive and PET-negative LNs. Comparisons were made using the Mann-Whitney -test and Student's -test. ROC curves were generated for each parameter to identify the optimal cut-off value for differentiation of the LNs. A systematic search in the literature was performed, exploring several databases, including PubMed, Scopus, the Cochrane library, and Embase.
A total of 105 LNs in 34 patients were analysed. The median ADC value of PET-positive LNs (0.907 × 10 mm/s [0.780-1.080]) was lower than that in PET-negative LNs (1.275 × 10 mm/s [1.063-1.525]) ( < 0.05). rADC and cADC values were lower in PET-positive LNs (rADC: 0.120 × 10 mm/s [-0.060-0.270]; cADC: 1.130 [0.980-1.420]) than in PET-negative LNs (rADC: 0.435 × 10 mm/s [0.225-0.673]; cADC: 1.615 [1.210-1.993]) LNs ( < 0.05). ADC showed the highest area under the curve (AUC 0.808).
Mean ADC, rADC, and cADC were significantly lower in the PET-positive group than in the PET-negative group. The ADC cut-off value of 1.149 × 10-3 mm/s showed the highest sensitivity. These results confirm the usefulness of ADC in differentiating metastatic from non-metastatic LNs in LACC.
评估表观扩散系数（ADC）值测量在局部晚期宫颈癌（LACC）患者转移性淋巴结（LN）诊断中的作用，并对相关文献进行系统综述。
回顾性评估LACC患者的磁共振成像（MRI）检查。测量肿大LN的平均ADC、相对ADC（rADC）和校正ADC（cADC）值，并在正电子发射断层扫描（PET）阳性和PET阴性的LN之间进行比较。采用Mann-Whitney检验和Student检验进行比较。为每个参数生成ROC曲线，以确定区分LN的最佳临界值。在包括PubMed、Scopus、Cochrane图书馆和Embase在内的多个数据库中进行文献系统检索。
共分析了34例患者的105个LN。PET阳性LN的ADC值中位数（0.907×10⁻³mm²/s[0.780 - 1.080]）低于PET阴性LN（1.275×10⁻³mm²/s[1.063 - 1.525]）（P<0.05）。PET阳性LN的rADC和cADC值（rADC：0.120×10⁻³mm²/s[-0.060 - 0.270]；cADC：1.130[0.980 - 1.420]）低于PET阴性LN（rADC：0.435×10⁻³mm²/s[0.225 - 0.673]；cADC：1.
