Diffusion-weighted imaging in the assessment of cervical cancer: comparison of reduced field-of-view diffusion-weighted imaging and conventional techniques.

Background: Cervical cancer (CC) is the second most common cancer in women worldwide. Diffusion-weighted imaging (DWI) plays an important role in the diagnosis of CC, but the conventional techniques are affected by many factors.
Purpose: To compare reduced-field-of-view (r-FOV) and full-field-of-view (f-FOV) DWI in the diagnosis of CC.
Material and Methods: Preoperative magnetic resonance imaging (MRI) with r-FOV and f-FOV DWI images were collected. Two radiologists reviewed the images using a subjective 4-point scale for anatomical features, magnetic susceptibility artifacts, visual distortion, and overall diagnostic confidence for r-FOV and f-FOV DWI. The objective features included the region of interest (ROI) signal intensity of the cervical lesion (SI _lesion ) and gluteus maximus muscle (SI _gluteus ), standard deviation of the background noise (SD _background ), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The differences of measured apparent diffusion coefficient (ADC) values between the two examinations in pathological grades and FIGO tumor stages were compared.
Results: A total of 200 patients were included (170 with squamous cell carcinoma and 30 with adenocarcinoma). The scores of anatomical features, magnetic susceptibility artifacts, visual distortion, and overall diagnostic confidence for r-FOV DWI were significantly higher than those for f-FOV DWI. There was no difference in SNR and CNR between r-FOV DWI and f-FOV DWI. There were significant differences in ADC values between the two groups in all comparisons ( P  < 0.05).
Conclusion: Compared with f-FOV DWI, r-FOV DWI might provide clearer imaging, fewer artifacts, less distortion, and higher image quality for the diagnosis of CC and might assist in the detection of CC.