The value of 3.0Tesla diffusion-weighted MRI for pelvic nodal staging in patients with early stage cervical cancer
European Journal of Cancer, 07/30/2012

Klerkx WM et al. – Diffusion–weighted magnetic resonance imaging (MRI) did not result in additional diagnostic value compared to conventional MRI.

• 68 federation internationale de gynecologie obstetrique (FIGO) stage Ia2 to IIb cervical cancer patients were included.
• Sensitivity and specificity rates for two experienced observers were computed for the detection of lymphatic metastasis.
• Reproducibility of conventional MRI was tested by kappa statistics.
• The variables included in the analysis were: size of the long axis, short axis, ratio short to long axis and apparent diffusion coefficient (ADC).

• Nine patients had 15 positive pelvic nodes at histopathological examination.
• The sensitivity and specificity of lymphatic metastasis detection by predefined conventional MRI characteristics was 33% (95% Confidence Interval (CI) 3–64) and 83% (95% CI 74–93) on patient level, and 33% (95% CI 7–60) and 97% (95% CI 95–99) on regional level respectively for observer 1.
• For observer 2 the sensitivity was 33% (95% CI 3–64) and the specificity 93% (95% CI 87–100) on patient level, and 25% (95% CI 1–50) and 98% (95% CI 97–100) on regional level, respectively.
• The kappa-value for reproducibility of metastasis detection on regional level was 0.50.
• The short axis diameter showed the highest diagnostic accuracy (area under the curve (AUC)=0.81 95% CI 0.70–0.91); ADC did not improve diagnostic accuracy (AUC=0.83 95% CI 0.73–0.93).