The Value of Diffusion-Weighted Imaging in Predicting the Prognosis of Stage IB-IIA Cervical Squamous Cell Carcinoma after Radical Hysterectomy

Abstract

Objective The aim of the study was to investigate the value of mean apparent diffusion coefficient (ADCmean) value in predicting the prognosis of stage IB-IIA cervical squamous cell carcinoma (SCC) patients after radical hysterectomy. Materials and Methods A total of 126 patients who were with stage IB-IIA cervical SCC and underwent magnetic resonance imaging examination and radical hysterectomy were retrospectively investigated. Receiver operating characteristic curve was used to determine the cutoff values of ADCmean for predicting earlier recurrence (2 consecutive increases in the SCC antigen value of more than 1 ng/mL or elevation of greater than 1.5 ng/mL). Disease-free survival and overall survival were analyzed using the Kaplan-Meier method, and differences between the survival curves were examined using the log-rank test. Results Earlier recurrence was observed in 46 patients (36.2%) during a median follow-up of 22 months. The ADCmean value (P = 0.005), parametrial invasion (P = 0.049), and lymphovascular space invasion (P = 0.037) were significantly associated with earlier recurrence. Receiver operating characteristic curve identified that the cutoff value of ADCmean for predicting earlier recurrence was 0.785 × 10-3mm2/s. The ADCmean value, parametrial invasion, and lymphovascular space invasion were significantly associated with earlier recurrence. The hazard ratios were 7.33 (95% confidence interval [95% CI], 1.854-28.99), 4.88 (95% CI, 1.00-23.73), and 2.53 (95% CI, 1.058-6.052), respectively. Disease-free survival and overall survival rates of patients with the ADCmean less than 0.785 × 10-3mm2/s were significantly worse than those of patients with the ADCmean greater than or equal to 0.785 × 10-3mm2/s. Conclusions Mean ADC was a good biomarker in predicting the prognosis of stage IB-IIA cervical SCC after radical hysterectomy.