Value of diffusion-weighted MRI in assessment of surgical margin of cervical cancer after loop electrosurgical excision procedure

Purpose of investigation: To investigate the value of magnetic resonance (MR) diffusion-weighted imaging (DWI) and its derived parameter of apparent diffusion coefficient (ADC), in evaluating surgical margin for cervical cancer after loop electrosurgical excision procedure (LEEP). Materials and Methods: The authors included 50 cervical cancer patients as the LEEP group and 70 patients with no cervical lesions as the control group. All patients underwent routine pelvic MR and DWI examinations. The LEEP group was separated into two subgroups according to histopathological study results, i.e., negative surgical margin group and positive surgical margin group. The ADC values were calculated and compared between different groups. ROC curve was employed to investigate the discriminatory capability of the ADC values. Results: The mean ADC values in the control group, the negative surgical margin, and the positive surgical margin group were 1.393 ± 0.199×10-3 mm2 /S, 1.259 ± 0.157×10-3 mm2 /S, and 0.961 ± 0.179×10-3 mm2 /S, respectively. Significant difference was observed between any two of the three groups (p < 0.01). Conclusion: The application of DWI with ADC value analysis considerably improved the differentiation of normal cervix tissue from post-treatment inflammation reaction and residual tumor in cervical cancer patients after LEEP therapy.

Cervical cancer; Magnetic resonance imaging; DWI; ADC; Loop electrosurgical excision procedure.

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