Evaluation of International Federation of Gynecology and Obstetrics Stage IB Cervical Cancer: Comparison of Diffusion-Weighted and Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 3.0 T

Objective: The objective of this study was to compare the diagnostic performance of diffusion-weighted (DW) imaging with that of dynamic contrast-enhanced (DCE) imaging in the evaluation of tumor extent in patients with stage IB cervical cancer. Methods: This retrospective study was approved by the institutional review board. Between June 2010 and March 2012, 46 consecutive patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB who underwent preoperative DCE, DW (b = 0 and 800 s/mm(2)), and T1- and T2-weighted imaging were included in this study. Two radiologists independently evaluated the extent of cervical cancer and made a diagnosis of tumor stage according to the revised FIGO staging system. The staging accuracy by DCE and DW for readers 1 and 2 was compared with the McNemar test, and kappa statistics were used for reader agreement. Results: No statistical difference between the diagnostic performance of staging with DCE and with DW was observed in reader 1 (P = 1.000) or in reader 2 (P = 0.109). Interobserver agreement between the 2 readers for staging was both substantial with DCE (kappa = 0.750, P < 0.001) and with DW (kappa = 0.683, P < 0.001). Conclusions: The diagnostic performance of DW in distinguishing the subdivision of stage IB cervical cancer was not statistically different from that of DCE. Diffusion-weighted imaging may be preferable to DCE for the preoperative evaluation of stage IB cervical cancer.