The Value Of Diffusion-weighted Imaging(DWI) In Preoperative Evaluation Of Cervical Cancer

Objective:To explore the value of diffusion-weighted imaging（DWI）in preoperative evaluation of cervical cancer.Methods:A total of 273 patients with International Federation of Gynecology and Obstetrics 2018 stages IB1 to IIIC1 cervical cancer who underwent pelvic 3.0T-MRI including MRI and DWI were enrolled in this study.Comparing the diagnostic value of preoperative stage of cervical cancer between MRI group and DWI group.The ADCmean of the tumors was measured in DWI to explore the expression of ADCmean in different pathological characteristics and to draw the ROC curve of ADCmean predicting the postoperative supplementary therapy.Results:The diagnostic coincidence rate of DWI was higher than that of MRI in the preoperative staging of cervical cancer（χ²,P<0.05）,the coincidence rate was 90.91%,93.48%,95.16%.And the DWI staging was in great consistency with the postoperative pathological staging（Kappa value=0.854,P<0.001）.There were significant differences in the expression of ADCmean in pathological types,histological differentiation,depth of stromal infiltration,tumor diameter,lymphovascular invasion,and pelvic lymph node metastasis of cervical cancer（all P<0.05）.The area under the ROC curve was 0.815,with the best predictive value for postoperative supplementary therapy in cervical cancer（sensitivity 80.0%,specificity74.0%）,when the ADCmean was 0.910×10^-3mm²/s.Conclusions:DWI is an important tool for preoperative evaluation of cervical cancer.The expression of ADCmean in local cervical lesions varies in different clinicopathological characteristics,and ADCmean(<0.910×10^-3mm²/s)may be an important reference index to predict the need for postoperative supplementary therapy.