Value of Diffusion Weighted Magnetic Resonance Imaging in Diagnosis of Cervical Carcinoma

Abstract
Background: Carcinoma of the uterine cervix is the third most frequently diagnosed malignancy in women worldwide. It remains a leading cause of cancer-related death for women in developing countries. Conventional MRI has an established role in gynecologic imaging. However, increasing clinical demand for improved lesion characterization and disease mapping to optimize patient management has resulted in the incorporation of newer sequences, such as diffusion-weighted imaging (DWI). Aim of Study: The aim of this study is to evaluate the role of DW-MRI in the diagnosis of cervical carcinoma. Patients and Methods: This is a descriptive exploratory (case-series) study that included 20 female patients diagnosed with cervical cancer, Pelvic MR, DWI and DCE- MR were done for all patient. The study was conducted in El-Demerdash Hospital from March 2019 – Feb. 2020. Results: This study group consisted of 20 female patients diagnosed with cancer cervix, Pelvic MR with DWI and DCE-MR were done for all patients. Lesions in all cases were seen restricted on DWI (high signal intensity in DWI with low ADC map) with hetrogenous patterns was seen in (17/20, 85%) cases, homogenous patterns was seen in (2/20, 10%) and mural pattern in (1/20,5%) case. All lesions showed low ADC maps from 0.6 to 1.2 (x10-3mm2/sec), <0.8 x10-3mm2/ sec was seen in 5 cases (25%) and ³0.8 x10-3mm2/sec was seen in 15 cases (75%). A total 20 cervical cancer lesions, 5 lesions were stage IIA (25%), 10 lesions were stage IIB(10%), 4 lesions were stage IVA (20%) and 1 lesion was stage IVB (5%) of figo classification. Conclusion: DWI is a potentially useful adjunct to con-ventional MRI in the evaluation of gynecologic tumors, thus improving the overall diagnostic accuracy, tumor staging.