Prediction of lymphovascular space invasion in cervical carcinoma using diffusion kurtosis imaging

Abstract

Background: This study aimed to investigate the potential relationship between diffusion kurtosis imaging (DKI)- derived parameters and lymphovascular space invasion (LVSI) in patients with cervical carcinoma.

Patients and methods: This prospective study included 30 patients with cervical carcinoma. The patients underwent MRI, diffusion-weighted imaging (DWI), and DKI prior to surgery. The surgical pathology results were accepted as the reference standard for determining the LVSI status. The DKI-derived parameters, including mean diffusivity (MD) and mean kurtosis (MK), were measured. The apparent diffusion coefficient (ADC) value was also assessed.

Results: The MD value of LVSI positive cervical carcinomas was significantly lower than LVSI negative carcinomas (p-value = 0.01). MK value was significantly higher in LVSI positive tumors (p-value = 0.01). However, the ADC value did not show a significant difference between LVSI positive and LVSI negative tumors (p-value = 0.2). MD and MK parameters showed similar diagnostic accuracy in identifying the LVSI status, with the area under the curve of 0.77 and 0.78, respectively.

Conclusion: In this study, DKI-derived parameters were associated with the LVSI status in cervical carcinomas. Further studies with larger sample size are required to confirm these results.

Keywords: Cervical carcinoma; Diffusion kurtosis imaging; Diffusion-weighted imaging; Lymphovascular space invasion.