Objective:: To compare the performance of diffusion-weighted imaging (DWI) based on readout-segmented echo-planar imaging (RESOLVE) and single-shot EPI (SS-EPI) sequence in evaluating cervical cancer staging.
Methods:: 61 patients with cervical cancer underwent DWI based on SS-EPI and RESOLVE. Two blinded readers independently assessed two sets of DW images for distinction of anatomical structures, delineation of lesion, susceptibility artefact and overall image quality on a 4-point scale. Geometric distortion was evaluated by measuring lesion anteroposterior (AP) length and left-right (LR) width derived from T2W images and those obtained from the corresponding DW images. Staging of cervical cancer on SS-EPI and RESOLVE were compared with T2WI and gold-standard of pathological findings.
Results:: RESOLVE was significantly superior to SS-EPI for all four criteria regarding qualitative comparisons (all p < 0.05). Regarding the geometric distortion, AP length on SS-EPI was significantly different from that of T2WI (p < 0.05), whereas there were no significant differences between RESOLVE and T2WI (both p > 0.05). The staging of SS-EPI was overestimated, while RESOLVE had a better consistency with pathological staging than SS-EPI in staging of cervical cancer. There was no significant difference in apparent diffusion coefficient value between SS-EPI and RESOLVE (p < 0.05).
Conclusion:: RESOLVE is superior to SS-EPI in the accuracy of cervical cancer staging because of the improvement in image quality.
Advances in knowledge:: RESOLVE has a more accurate value comparable to SS-EPI in cervical cancer staging, with the advantage of the improvement in image quality and reduced geometric distortion.