Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-a pilot study

Objectives To investigate the tissue characteristics of cervical cancer based on intravoxel incoherent motion (IVIM) model and to differentiate cervical cancer from non-malignant tissues based on the IVIM characteristics. Methods Sixteen treatment-naïve cervical cancer and 17 age-matched healthy subjects were prospectively recruited for diffusion-weighted (b=0-1000 s/mm2) and standard pelvic MRI. Bi-exponential analysis was performed to derive the perfusion parameters, f (perfusion fraction), D* (pseudodiffusion coefficient) and the diffusion parameter, D (true molecular diffusion coefficient) in cervical cancer, normal cervix, myometrium and leiomyoma. Apparent diffusion coefficient (ADC) was calculated. Kruskal-Wallis test and receiver operating characteristics (ROC) curves were used. Results Cervical cancer had the lowest f (14.9±2.6%), significantly different from normal cervix and leiomyoma (p<0.05). The D (0.86±0.16 x 103 mm2/s) was also lowest in cervical cancer, significantly different from normal cervix and myometrium (p<0.05) but not with leiomyoma. No difference was observed in D*. D was consistently lower than ADC in all tissues. ROC curves identified f < 16.38%, D < 1.04 x 103 mm2/s and ADC