Apparent Diffusion Coefficient in MRI Scan and Cervix Squamous Cell Carcinoma Histopathologic Grade: A Correlational Study

Background: Currently, MRI examination is the main radiological diagnostic examination option for determining cervical cancer staging. Apparent diffusion coefficient (ADC) predicts changes in cell density due to water quantity and diffusion. This study aims to determine the correlation between ADC value and cervix SCC. Methods: This is a correlation study with retrospective design that was conducted at Radiology Installation of Dr. Soetomo General Hospital, Surabaya, Indonesia for 2 years. Sample of this study was all cervix cancer patients at Dr. Soetomo General Hospital, Surabaya who met inclusion criteria. Histopathologic grades were collected from histopathologic archives and ADC values were collected through DWI sequence in MRI. Descriptive analysis was carried out to obtain sample characteristics then continued with ROC analysis to obtain ADC cut off value and non-parametric Spearman's rho correlation test was conducted to determine the correlation between ADC values in cervix cancer which was categorized according to their histopathologic grade. Results: Sample distribution based on cervix cancer histopathologic grade from 48 samples showed that 27 patients (56.3%) had grade I SCC, eight patients (16.7%) had grade II, and 13 patients (27.1%) had grade III. Apparent diffusion coefficient cut-off value for grade I cervix cancer was 0.90 ± 0.18 x 10-3mm2/s, grade II was 0.83 ± 0.14 x 10-3mm2/s, and grade III was 0.82 ± 0.12 x 10-3mm2/s. Spearman's rho correlation test result was -0.169 and p = 0.250 (p>0.05). Conclusion: There was a very weak negative and non-significant correlation between ADC value and cervix squamous cell carcinoma histopathologic grade.