Value Of DWI And IVIM In Predicting Lymphovascular Space Invasion In Cervical Cancer

Objective:To assess the contributary value of intravoxel incoherent motion magnetic resonance imaging（IVIM-MRI）in the prediction of lymphovascular space invasion（LVSI）in patients with cervical cancer.Especially compared to the diffusion-weighted imaging（DWI）parameters.Material and Methods:One hundred and one patients with cervical cancer were retrospectively collected in the present study,which were classified into LVSI-positive and LVSI-negative groups according to postoperative pathology.Comparisons of the DWI parameters（ADC）and IVIM parameters（D,F,D*）,age and clinicopathological parameters between the two groups were performed.The relationships between LVSI,DWI parameters and IVIM parameters were analyzed using receiver operating characteristics（ROC）.Univariate and multivariate logistic regression models were used to investigate the optimal combination of imaging parameters for predicting LVSI.Results:ADCmin,Dmin,f values,FIGO stage,cervical stromal invasion depth,differentiation grade and postoperative pathological lymph node diagnosis were significantly different between patients with and without LVSI（p<0.05）.The ROC curves showed that ADC_min,D_min,f had a positive effect on predicting the diagnosis of LVSI（p<0.05）.The optimal cut-off threshold values for ADC_min,D_min,f value were0.83×10-3 mm2/s,0.61×10-3mm2/s,14.50%respectively.Univariate and multivariate logistic analysis shows that a combination of D_minin and f in LVSI diagnosis had excellent performance and showed better prediction than individual DWI parameters（difference between areas 0.141,P=0.0488）.Conclusion:LVSI is a prognostic factor of vital importance,the combination of D_minin and f may be the best parameter to predict the existence of LVSI.