T1 mapping and multimodel diffusion-weighted imaging in the assessment of cervical cancer: a preliminary study.

OBJECTIVE

To evaluate the clinical feasibility of T1 mapping and multimodel diffusion-weighted imaging (DWI) for assessing the histological type, grade, and lymphovascular space invasion (LVSI) of cervical cancer.

METHODS

Eighty patients with cervical cancer and 43 patients with a normal cervix underwent T1 mapping and DWI with 11 b-values (0-2000 s/mm). Monoexponential, biexponential, and kurtosis models were fitted to calculate the apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f), mean diffusivity (MD), and mean kurtosis (MK). Native T1 and DWI-derived parameters (ADC, ADC, D, D, D*, f, MD, MD, MK, and MK) were compared based on histological type, grade, and LVSI status.

RESULTS

Native T1 and DWI-derived parameters differed significantly between cervical cancer and normal cervix (all < 0.05), except D* ( 0.637). Native T1 and MK varied significantly between squamous cell carcinoma (SCC) and adenocarcinoma (both < 0.05). ADC, D, and MD were significantly lower while MK was significantly higher in the high-grade SCC group than in the low-grade SCC group (all < 0.05). LVSI-positive SCC had a significantly higher MK than LVSI-negative SCC ( < 0.05).

CONCLUSION

Both T1 mapping and multimodel DWI can effectively differentiate cervical cancer from a normal cervix and cervical adenocarcinoma from SCC. Furthermore, multimodel DWI may provide quantitative metrics for non-invasively predicting histological grade and LVSI status in SCC patients.

ADVANCES IN KNOWLEDGE

Combined use of T1 mapping and multimodel DWI may provide more comprehensive information for non-invasive pre-operative evaluation of cervical cancer.