Intravoxel incoherent motion diffusion weighted MRI of cervical cancer — Correlated with tumor differentiation and perfusion

ObjectivesTo investigate the value of parameters derived from IVIM model in grading of uterine cervical cancer and the relationship between perfusion parameters derived from IVIM and that from DCE-MRI.MethodsParameters of DWI (ADC, D, f, D*) and semi-quantitative parameters of DCE-MRI (Slop, Maxslop, CER, Washout, AUC90) were assessed in 24 female with cervical cancers. Except for ROIs encompassed all of the area of tumors in axial plane (A_all), ROIs on tumor edge (A_peri) and tumor center (A_central) were drawn. All of the parameters were compared among three pathology grades. Perfusion parameters derived from IVIM were correlated with that from DCE-MRI.ResultsFor G1, G2 and G3 tumors, on tumor edge ADC = (1.03 ± 0.11), (1.05 ± 0.10), (0.90 ± 0.05) × 10− 3 mm2/s, D = (0.80 ± 0.11), (0.78 ± 0.07), (0.69 ± 0.06) × 10− 3 mm2/s, and f = (0.19 ± 0.03), (0.22 ± 0.02), (0.24 ± 0.03). The differences among groups were significant (P < 0.05). On tumor center, ADC = (0.90 ± 0.10), (0.85 ± 0.03), (0.80 ± 0.07) × 10− 3 mm2/s with significant differences (P = 0.027). The other parameter, D and f of tumor center, as well as D* of all tumor areas, were of no statistic significance. Most of the DCE-MRI parameters negatively correlated with tumor volume. Although the correlation between f and slop was statistic significant, R = 0.277 meant a negligible correlation. f had week correlation with Maxslop, CER and AUC90 (R = 0.361, 0.400 and 0.405; P < 0.001). D* showed no statistic significant correlation with all of the DCE parameters.ConclusionIVIM model could possibly be used to evaluate tumor differentiation and perfusion, providing an alternative for DCE-MRI.