The role of apparent diffusion coefficient (ADC) in the evaluation of lymph node status in patients with locally advanced cervical cancer: our experience and a review
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Authors
Gui, Benedetta
Russo, Luca
Minordi, Laura
Miccò, Maura
Persiani, Salvatore
Avesani, Giacomo
Rufini, Vittoria
Fuoco, Valentina
Autorino, Rosa
Ferrandina, Gabriella
Issue Date
2022-08-10
Type
Article
Language
en_US
Keywords
Magnetic Resonance Imaging , Diffusion Magnetic Resonance Imaging , Uterine Cervical Neoplasms , Positron Emission Tomography/Computed Tomography
Alternative Title
Abstract
Purpose:
To evaluate the role of apparent diffusion coefficient (ADC) value measurement in the diagnosis of meta-static lymph nodes (LNs) in patients with locally advanced cervical cancer (LACC) and to present a systematic review of the literature.
Material and methods:
Magnetic resonance imaging (MRI) exams of patients with LACC were retrospectively eva-luated. Mean ADC, relative ADC (rADC), and correct ADC (cADC) values of enlarged LNs were measured and compared between positron emission tomography (PET)-positive and PET-negative LNs. Comparisons were made using the Mann-Whitney U-test and Student’s t-test. ROC curves were generated for each parameter to identify the optimal cut-off value for differentiation of the LNs. A systematic search in the literature was performed, exploring several databases, including PubMed, Scopus, the Cochrane library, and Embase.
Results:
A total of 105 LNs in 34 patients were analysed. The median ADC value of PET-positive LNs (0.907 × 10-3 mm2/s [0.780-1.080]) was lower than that in PET-negative LNs (1.275 × 10-3 mm2/s [1.063-1.525]) (p < 0.05). rADC and cADC values were lower in PET-positive LNs (rADC: 0.120 × 10-3 mm2/s [–0.060-0.270]; cADC: 1.130 [0.980-1.420]) than in PET-negative LNs (rADC: 0.435 × 10-3 mm2/s [0.225-0.673]; cADC: 1.615 [1.210-1.993]) LNs (p < 0.05). ADC showed the highest area under the curve (AUC 0.808).
Conclusions:
Mean ADC, rADC, and cADC were significantly lower in the PET-positive group than in the PET-negative group. The ADC cut-off value of 1.149 × 10-3 mm2/s showed the highest sensitivity. These results confirm the usefulness of ADC in differentiating metastatic from non-metastatic LNs in LACC.
Description
Citation
Gui, B., Russo, L., Minordi, L., Miccò, M., Persiani, S., Avesani, G., Rufini, V., Fuoco, V., Autorino, R., Ferrandina, G., Scambia, G., & Manfredi, R. (2022). The role of apparent diffusion coefficient (ADC) in the evaluation of lymph node status in patients with locally advanced cervical cancer: our experience and a review. Polish journal of radiology, 87, e438–e447. https://doi.org/10.5114/pjr.2022.118914
Publisher
Polish Journal of Radiology