Feasibility of diffusion-weighted imaging in the differentiation of metastatic from nonmetastatic lymph nodes: Early experience

Purpose: To investigate the feasibility of diffusion-weighted imaging (DWI) in the differentiation of metastatic from non-metastatic lymph nodes. Materials and Methods: In 125 patients who underwent lymph node dissection for uterine cervical cancer, DWI was performed at b value of 0 and 1000 s/mm(2). By referring to the surgical maps of the pelvic lymph nodes, the apparent diffusion coefficient (ADC) was compared in the metastatic and nonmetastatic lymph nodes, and receiver-operating-characteristics analysis was performed to evaluate the diagnostic performance of the ADC in differentiating metastatic from nonmetastatic lymph nodes. Results: The ADC were significantly lower in the metastatic lymph nodes (0.7651 x 10(-3) mm(2)/s +/- 0.1137) than in the nonmetastatic lymph nodes (1.0021 x 10(-3) mm(2)/s +/- 0.1859: P < 0.001). The area-under-the-curve of ADC for differentiating metastatic from nonmetastatic lymph nodes, was 0.902. The sensitivity and specificity of ADC for differentiating metastatic from nonmetastatic lymph nodes, were 87% for the ADC and 80%, respectively. Conclusion: DWI is feasible for differentiating metastatic from nonmetastatic lymph nodes in patients with uterine cervical cancer.