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The Value of Diffusion-Weighted Imaging in Combination With Conventional Magnetic Resonance Imaging for Improving Tumor Detection for Early Cervical Carcinoma Treated With Fertility-Sparing Surgery
  1. Xiulei Li, MD*,
  2. Ling Wang, MD*,
  3. Yong Li, MD and
  4. Peiji Song, MD
  1. *Department of Radiotherapy, Liaocheng People’s Hospital;
  2. Department of Computed Tomography, Liaocheng Third People’s Hospital; and
  3. Department of Computed Tomography, Liaocheng People’s Hospital, Liaocheng City, Shandong Province, China.
  1. Address correspondence and reprint requests to Peiji Song, MD, Department of CT, Liaocheng People’s Hospital, Dongchang Rd 67, Liaocheng City, Shandong 25200, China. E-mail:


Objective This study aimed to investigate the value of diffusion-weighted imaging (DWI) in combination with conventional magnetic resonance imaging (MRI) for improving tumor detection in young patients treated with fertility-sparing surgery because of early cervical carcinoma.

Methods Fifty-four patients with stage Ia or Ib1 cervical carcinoma were enrolled into this study. Magnetic resonance examinations were performed for these patients using conventional MRI (including T1-weighted imaging, T2-weighted imaging, and dynamic contrast-enhanced MRI) and DWI. The apparent diffusion coefficient (ADC) values of cervical carcinoma were analyzed quantitatively and compared with that of adjacent epithelium. Sensitivity, positive predictive value, and accuracy of 2 sets of MRI sequences were calculated on the basis of histologic results, and the diagnostic ability of conventional MRI/DWI combinations was compared with that of conventional MRI.

Results The mean ADC value from cervical carcinoma (mean, 786 × 10−6 mm2/s ± 100) was significantly lower than that from adjacent epithelium (mean, 1352 × 10−6 mm2/s ± 147) (P = 0.01). When the threshold ADC value set as 1010 × 10−6 mm2/s, the sensitivity and specificity for differentiating cervical carcinoma from nontumor epithelium were 78.2% and 67.2%, respectively. The sensitivity and accuracy of conventional MRI for tumor detection were 76.0% and 70.4%, whereas the sensitivity and accuracy of conventional MRI/DWI combinations were 91.7% and 90.7%, respectively. Conventional MRI/DWI combinations revealed a positive predictive value of 97.8% and only 4 false-negative findings.

Conclusions The addition of DWI to conventional MRI considerably improves the sensitivity and accuracy of tumor detection in young patients treated with fertility-sparing surgery, which supports the inclusion quantitative analysis of ADC value in routine MRI protocol before fertility-sparing surgery.

  • Cervical carcinoma
  • Fertility-sparing surgery
  • Tumor detection
  • Diffusion-weighted imaging
  • Conventional MRI

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  • The authors declare no conflicts of interest.