Purpose: to evaluate the role of DW imaging in the detection of cervical and endometrial cancers and correlate the histopathological grading and ADC values.
Materials and Methods:
53 women with positive biopsy for cervical and endometrial cancer enrolled in the study underwent MR examination; based on biopsy 34/53 patients had cervical cancer and 19/53 patients had endometrial cancer.
MR study protocol included DWI sequence obtained with a single-shot echo-planar sequence (EPI) in the axial or sagittal plane, with b value of 500s/mm2.
MR protocol also included fast spin-echo T2w.i. sequences acquired in the sagittal and axial planes.
Lesions’ signal intensity and ADC values were evaluated on DWI images. Lesions’ signal intensities on T2w.i and maximum diameter were also collected.
Student’s t test was applied for statistical analysis of collected data; a two tailed p-value of less than 0.05 was considered as significant.
Results:
On DWI, only 30/53 tumors were appreciable , in particular 29/30 lesions (96.7%) were cervical cancers; 1/19 was an endometrial cancer; 18/19 endometrial cancers and 5/34 cervical cancers were not detectable on DWI images.
No relationship was found between cervical cancers’ size and lesions’ signal intensity on DWI nor lesions’ signal intensity on T2w.i. (p>.05).
Mean ADC values of G1 graded cervical cancers resulted to be significantly higher than ADC values of G2 and G3 graded neoplasms (p<.05).
Conclusion: DWI can help in detecting the presence of cervical tumor, while it does not result useful in assessing the presence of endometrial neoplasms.
ADC values of well differentiated cervical cancers are higher than relative values of more de-differentiated neoplasms