Node-by-node correlation between MR and PET/CT in patients with uterine cervical cancer: diffusion-weighted imaging versus size-based criteria on T2WI

Abstract

The purpose of the study was to perform a node-by-node comparison of an ADC-based diagnosis and various size-based criteria on T2-weighted imaging (T2WI) with regard to their correlation with PET/CT findings in patients with uterine cervical cancer. In 163 patients with 339 pelvic lymph nodes (LNs) with short-axis diameter >5 mm, the minimum apparent diffusion coefficient (ADC), mean ADC, short- and long-axis diameters, and ratio of long- to short-axis diameters (L/S ratio) were compared in PET/CT-positive and -negative LNs. On PET/CT, 118 (35%) LNs in 58 patients were positive. The mean value of minimum and mean ADCs, short- and long-axis diameters, and L/S ratio were different in PET/CT-positive (0.6436 x 10(-3) mm(2)/s, 0.756 x 10(-3) mm(2)/s, 10.3 mm, 13.2 mm, 1.32, respectively) and PET/CT-negative LNs (0.8893 x 10(-3) mm(2)/s, 1.019 x 10(-3) mm(2)/s, 7.4 mm, 11.0 mm, 1.49, respectively) (P < 0.05). The Az value of the minimum ADC (0.864) was greater than those of mean ADC (0.836), short-axis diameter (0.764), long-axis diameter (0.640) and L/S ratio (0.652) (P < 0.05). The sensitivity and accuracy of the minimum ADC (86%, 82%) were greater than those of the short-axis diameter (55%, 74%), long-axis diameter (73%, 58%) and L/S ratio (52%, 66%) (P < 0.05). ADC showed superior correlation with PET/CT compared with conventional size-based criteria on T2WI.

Complementary Roles of Whole-Body Diffusion-Weighted MRI and18F-FDG PET: The State of the Art and Potential Applications

“…Choi et al (55) retrospectively investigated 236 patients with uterine cervical cancer who had undergone both DWI and 18 F-FDG PET/CT within a 2-wk interval. Only 1 "representative" lymph node with a short-axis diameter of 5 mm or greater on T2-weighted images was selected per lymph node station.…”

Computed diffusion-weighted MRI for prostate cancer detection: the influence of the combinations ofb-values

“…[1][2][3] Prostate cancer (PCa) detection is sometimes difficult because of the high background signal of parenchyma due to the presence of hypertrophy, bleeding and inflammation.…”

Evaluation of lymph node metastases: Comparison of gadofluorine M‐enhanced MRI and diffusion‐weighted MRI in a rabbit VX2 rectal cancer model

“…However, until now there has been no comparative study of the diagnostic performance of DWI and gadofluorine Menhanced imaging. Furthermore, from a methodological perspective, the radiologic-pathologic correlation on a per-LN basis is the challenging obstacle for assessment of the accuracy of diagnostic imaging tests for identifying metastatic LNs in human rectal cancer (23,24).…”