The Egyptian Journal of Radiology and Nuclear Medicine (Dec 2017)
Is there an added role for diffusion weighted imaging in the staging of cervical carcinoma?
Abstract
Objective: To assess the diagnostic accuracy of diffusion weighted imaging (DWI-MRI) being a non-contrast based MR sequence versus dynamic contrast enhanced MRI (DCE-MRI) in the preoperative loco-regional staging of the cervical carcinoma. Methodology: Fifty cases of proved cancer cervix prior staging subjected to dynamic post contrast technique: one pre-and six post contrast phases (40 s each). DWI was scanned using different b values and ADC values were measured. Results: DWI was the most accurate in staging operable cases (93.3%).Parametrial infiltration was overestimated in 3 cases versus 4 cases in DCE-MR. DWI showed 100% sensitivity, positive predictive value and accuracy in the assessment of locally advanced carcinomas. In metastatic lymph nodes, DCE-MR showed the least accuracy of 86%. Conclusion: DWI is helpful in discriminating local from locally advanced cervical carcinomas. DCE-MR can delineate cervical carcinomas confined to the uterus and exclude bladder/rectal invasion.
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