T1 mapping and multimodel diffusion-weighted imaging in the assessment of cervical cancer: a preliminary study.

OBJECTIVE: To evaluate the clinical feasibility of T1 mapping and multimodel diffusion-weighted imaging (DWI) for assessing the histological type, grade, and lymphovascular space invasion (LVSI) of cervical cancer.

METHODS: Eighty patients with cervical cancer and 43 patients with a normal cervix underwent T1 mapping and DWI with 11 b-values (0-2000 s/mm2 ). Monoexponential, biexponential, and kurtosis models were fitted to calculate the apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f), mean diffusivity (MD), and mean kurtosis (MK). Native T1 and DWI-derived parameters (ADCmean , ADCmin , Dmean , Dmin , D*, f, MDmean , MDmin , MKmean , and MKmax ) were compared based on histological type, grade, and LVSI status.

RESULTS: Native T1 and DWI-derived parameters differed significantly between cervical cancer and normal cervix (all p < 0.05), except D* ( p = 0.637). Native T1 and MKmean varied significantly between squamous cell carcinoma (SCC) and adenocarcinoma (both p < 0.05). ADCmin , Dmin , and MDmin were significantly lower while MKmax was significantly higher in the high-grade SCC group than in the low-grade SCC group (all p < 0.05). LVSI-positive SCC had a significantly higher MKmean than LVSI-negative SCC ( p < 0.05).

CONCLUSION: Both T1 mapping and multimodel DWI can effectively differentiate cervical cancer from a normal cervix and cervical adenocarcinoma from SCC. Furthermore, multimodel DWI may provide quantitative metrics for non-invasively predicting histological grade and LVSI status in SCC patients.

ADVANCES IN KNOWLEDGE: Combined use of T1 mapping and multimodel DWI may provide more comprehensive information for non-invasive pre-operative evaluation of cervical cancer.