Purpose: To analyze the influence of different b-value combinations on apparent diffusion coefficient (ADC)-based differentiation of known malignant and benign tissue in cervical cancer patients. Materials and Methods:A total of 35 patients with stage IB1, IB2, IIA cervical cancer underwent a 3.0T MRI scan prior to radical hysterectomy and pelvic lymph node dissection. Conventional T1-and T2-weighted sequences and a diffusion-weighted sequence (b ¼ 0, 150, 500, 1000 seconds/mm 2 ) were performed. Regions-of-interest (ROI) were drawn on ADC maps derived from five different bvalue combinations (0, 500; 0, 150, 500; 0, 1000; 0, 150, 500, 1000; 150, 500, 1000 seconds/mm 2 ). The influence of the b-value combination on ADC-based differentiation of benign and malignant tissue was analyzed using receiveroperating-characteristics curves.Results: For all b-value combinations, ADCs were significantly lower (P < 0.001) in cervical malignancies (1.15 6 0.21Á10 Conclusion: ADC-based differentiation of benign from malignant cervical tissue is independent of the tested bvalue combinations. The results support the inclusion and possible pooling of studies using different b-value combinations in meta-analyses on ADC-based tissue differentiation in cervical cancer.

Diffusion-weighted MRI did not result in additional diagnostic value compared to conventional MRI.

The overall accuracy of gadolinium-enhanced magnetic resonance imaging for the detection of nodal metastases is moderate. Incorporating contrast enhancement in the malignancy criteria substantially improves the accuracy of this diagnostic test.

Purpose: To perform a longitudinal analysis of changes in lymph node volume and apparent diffusion coefficient (ADC) in healthy, metastatic, and hyperplastic lymph nodes. Materials and Methods:Three groups of four female Copenhagen rats were studied. Metastasis was induced by injecting cells with a high metastatic potential in their left hind footpad. Reactive nodes were induced by injecting Complete Freund Adjuvant (CFA). Imaging was performed at baseline and at 2, 5, 8, 11, and 14 days after tumor cell injection. Finally, lymph nodes were examined histopathologically. Results:The model was highly efficient in inducing lymphadenopathy: subcutaneous cell or CFA inoculation resulted in ipsilateral metastatic or reactive popliteal lymph nodes in all rats. Metastatic nodal volumes increased exponentially from 5-7 mm 3 at baseline to 25 mm 3 at day 14, while the control node remained 5 mm 3 . The hyperplastic nodes showed a rapid volume increase reaching a plateau at day 6. The ADC of metastatic nodes significantly decreased (range 13%-32%), but this decrease was also seen in reactive nodes.Conclusion: Metastatic and hyperplastic lymph nodes differed in terms of enlargement patterns and ADC changes. Enlarged reactive or malignant nodes could not be differentiated based on their ADC values.

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Introduction and hypothesis Chronic pelvic pain (CPP) is a common multifactorial condition affecting 6 to 27% of women aged 18–50 years worldwide. This study was conducted to review and meta-analyse the current literature on the reduction of chronic pelvic pain after botulinum toxin A (BTA) injection. Method In July 2021 we performed a systematic search in PubMed and EMBASE to assess the benefits of BTA injection in pelvic floor muscles in women with chronic pelvic pain. Primary outcome was reduction in visual analogue scale (VAS) after treatment. Secondary outcomes evaluated were: reduction of dyspareunia, pelvic floor resting pressure and quality of life. Identified reports were assessed on quality of reporting and risk of bias. Standardized mean difference (SMD) was used to combine and analyse outcomes of the included studies. Results Eight studies with 289 participants were considered eligible to be included in this systematic review and meta-analysis. After recalculating SMD into VAS scores (0–100), long-term follow-up (24–26 weeks) showed a significant 15-point improvement in VAS scores (95% CI: 8.8–21.5) for non-menstrual pelvic pain and a 13-point improvement (95% CI: 2.1–24.0) for dyspareunia. BTA injection had a significant effect on pelvic floor resting pressure and quality of life. Conclusion There is limited scientific evidence on the effectiveness of BTA injections in pelvic floor muscles in women with chronic pelvic pain. The available studies show that BTA injections significantly reduce pain levels and improve quality of life at 6 months follow-up. Prospero ID CRD42018105204.

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