Perfusion parameters of intravoxel incoherent motion based on tumor edge region of interest in cervical cancer: evaluation of differentiation and correlation with dynamic contrast-enhanced MRI

Abstract

Background Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) is a functional magnetic resonance imaging (MRI) sequence. Purpose To evaluate the value of perfusion parameters derived from IVIM-DWI based on tumor edge region of interest (ROI) in differentiation in cervical cancer and investigate the relationship between IVIM and dynamic contrast-enhanced MRI (DCE-MRI). Material and Methods Thirty-three patients with pathologically diagnosed squamous cell carcinoma who underwent IVIM-DWI (nine b-values: 1–1000 s/mm2) and DCE-MRI were retrospectively assessed in this study. Parameters of IVIM (D, f, D*, fD*) and quantitative parameters of DCE-MRI (Ktrans, Kep, Ve) were derived using tumor edge ROI. Mann–Whitney U test was used to compare parameters between pathological grades and receiver operating characteristic (ROC) curves were used. Pearson’s correlation coefficient (r) evaluated the correlation between perfusion parameters derived from IVIM and DCE-MRI. Results The poorly differentiated group showed the significantly lower D value and the higher f, Ktrans and Kep values than the well-to-moderately differentiated group ( P < 0.05). ROC curves indicated that f < 26%, Ktrans <0.38/min, and Kep <1.62/min could differentiate the poorly differentiated group from the well-to-moderately differentiated group (AUC 0.753–0.808). Significantly positive correlations were found between f and Ktrans (r = 0.422, P = 0.014) and between fD* and Ktrans (r = 0.448, P = 0.009). Conclusion Perfusion parameters derived from IVIM based on tumor edge ROI may offer additional value in differentiation in cervical cancer, and the IVIM perfusion parameters showed moderate positive correlations with quantitative perfusion parameters from DCE-MRI, while f and fD* showed promising significance.