• Shujian Li, Jie Liu, Feifei Zhang, Meng Yang, Zanxia Zhang, Jingjing Liu, Yong Zhang, Tom Hilbert, Tobias Kober, Jingliang Cheng, and Jinxia Zhu.
• Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
• J Magn Reson Imaging. 2020 Dec 1; 52 (6): 1859-1869.

BackgroundThe application value of T2 mapping in evaluating cervical cancer (CC) features remains unclear.PurposeTo investigate the role of T2 values in evaluating CC classification, grade, and lymphovascular space invasion (LVSI) in comparison to apparent diffusion coefficient (ADC), and to compare synthetic T2 -weighted (T2 W) images calculated from T2 values to conventional T2 W images for CC staging.Study TypeRetrospective.PopulationSixty-three patients with histopathologically confirmed CC.Field Strength/Sequence3T, conventional T2 W turbo spin-echo, diffusion-weighted echo-planar, and accelerated T2 mapping sequence.AssessmentT2 and ADC values between different pathological features of CC were compared. The diagnostic accuracies of conventional and synthetic T2 W images in staging were also compared.Statistical TestsParameters were compared using an independent t-test, Wilcoxon signed-rank test, and the chi-square test. Receiver operating characteristic analysis was performed.ResultsThe T2 values varied significantly between well/moderately differentiated and poorly differentiated tumors ([92.8 ± 9.5 msec] vs. [83.8 ± 9.5 msec], P < 0.05) and between LVSI-positive and LVSI-negative CC ([82.2 ± 8.2 msec] vs. [93.9 ± 9.1 msec], P < 0.05). The ADC values showed a significant difference for grade ([0.76 ± 0.10 × 10-3 mm2 /s] vs. [0.65 ± 0.11 × 10-3 mm2 /s], P < 0.05) and no difference for LVSI status ([0.71 ± 0.11× 10-3 mm2 /s] vs. [0.73 ± 0.12× 10-3 mm2 /s], P = 0.472). There was no significant difference in T2 and ADC values between squamous cell carcinoma and adenocarcinoma (P = 0.378 and P = 0.661, respectively). In MRI staging, the conventional and synthetic T2 W images resulted in a similar accuracy (71% vs. 68%, P = 0.698).Data ConclusionThe accelerated T2 mapping sequence may facilitate grading and staging of CC by providing quantitative T2 maps and synthetic T2 W images in one acquisition. T2 values may be superior to ADC in predicting LVSI.Level Of Evidence2 TECHNICAL EFFICACY STAGE: 2 J. MAGN. RESON. IMAGING 2020;52:1859-1869.© 2020 International Society for Magnetic Resonance in Medicine.

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