Novel T2 Mapping for Evaluating Cervical Cancer Features by Providing Quantitative T2 Maps and Synthetic Morphologic Images: A Preliminary Study.

BACKGROUND: The application value of T2 mapping in evaluating cervical cancer (CC) features remains unclear. PURPOSE: To investigate the role of T2 values in evaluating CC classification, grade, and lymphovascular space invasion (LVSI) in comparison to apparent diffusion coefficient (ADC), and to compare synthetic T2 -weighted (T2 W) images calculated from T2 values to conventional T2 W images for CC staging. STUDY TYPE: Retrospective. POPULATION: Sixty-three patients with histopathologically confirmed CC. FIELD STRENGTH/SEQUENCE: 3T, conventional T2 W turbo spin-echo, diffusion-weighted echo-planar, and accelerated T2 mapping sequence. ASSESSMENT: T2 and ADC values between different pathological features of CC were compared. The diagnostic accuracies of conventional and synthetic T2 W images in staging were also compared. STATISTICAL TESTS: Parameters were compared using an independent t-test, Wilcoxon signed-rank test, and the chi-square test. Receiver operating characteristic analysis was performed. RESULTS: The T2 values varied significantly between well/moderately differentiated and poorly differentiated tumors ([92.8 ± 9.5 msec] vs. [83.8 ± 9.5 msec], P < 0.05) and between LVSI-positive and LVSI-negative CC ([82.2 ± 8.2 msec] vs. [93.9 ± 9.1 msec], P < 0.05). The ADC values showed a significant difference for grade ([0.76 ± 0.10 × 10-3 mm2 /s] vs. [0.65 ± 0.11 × 10-3 mm2 /s], P < 0.05) and no difference for LVSI status ([0.71 ± 0.11× 10-3 mm2 /s] vs. [0.73 ± 0.12× 10-3 mm2 /s], P = 0.472). There was no significant difference in T2 and ADC values between squamous cell carcinoma and adenocarcinoma (P = 0.378 and P = 0.661, respectively). In MRI staging, the conventional and synthetic T2 W images resulted in a similar accuracy (71% vs. 68%, P = 0.698). DATA CONCLUSION: The accelerated T2 mapping sequence may facilitate grading and staging of CC by providing quantitative T2 maps and synthetic T2 W images in one acquisition. T2 values may be superior to ADC in predicting LVSI. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.