Diffusion Kurtosis Imaging in the Assessment of Cervical Carcinoma

Abstract

To evaluate the additional value of diffusion kurtosis imaging (DKI) in the characterization of cervical carcinoma. Seventy-five patients (56.9 ± 13.4 years) with histologic-confirmed cervical carcinoma were included. Diffusion-weighted imaging (DWI) was acquired on a 3T MRI with five b values (0, 500, 800, 1000, and 1500 s/mm2). Data were analyzed based on DKI model (5 b values) and conventional DWI (0 and 1000 s/mm2). Largest single-slice region of interest (ROI) and volume of interest (VOI) were drawn around the tumor. Mean diffusivity (MD), mean kurtosis (MK), and apparent diffusion coefficient (ADC) of cervical carcinoma and normal myometrium were measured and compared. MD, MK, and ADC of cervical carcinoma were compared among histologic subtypes, tumor grades, and FIGO stages. ROI- and VOI-derived DKI parameters and ADC were all in excellent consistency (intraclass correlation coefficient, ICC > 0.90, respectively). Cervical carcinoma had significantly lower MD, ADC, and higher MK than normal myometrium (p < 0.001). MD and ADC showed significant differences between histologic subtypes and FIGO stages, lower in squamous cell carcinoma than adenocarcinoma and higher in FIGO I-II than FIGO III-IV (p < 0.050), but not with tumor grade. No difference was observed in MK for different clinicopathologic features tested. ROI and VOI analyses were in excellent consistency. MD and ADC were able to distinguish histologic subtypes and separating FIGO stages, MK could not. DKI showed no clear added value over conventional DWI in the characterization of cervical carcinoma.