Novel T2 Mapping for Evaluating Cervical Cancer Features by Providing Quantitative T2 Maps and Synthetic Morphologic Images: A Preliminary Study

Background The application value of T 2 mapping in evaluating cervical cancer (CC) features remains unclear. Purpose To investigate the role of T 2 values in evaluating CC classification, grade, and lymphovascular space invasion (LVSI) in comparison to apparent diffusion coefficient (ADC), and to compare synthetic T 2 ‐weighted (T 2 W) images calculated from T 2 values to conventional T 2 W images for CC staging. Study Type Retrospective. Population Sixty‐three patients with histopathologically confirmed CC. Field Strength/Sequence 3T, conventional T 2 W turbo spin‐echo, diffusion‐weighted echo‐planar, and accelerated T 2 mapping sequence. Assessment T 2 and ADC values between different pathological features of CC were compared. The diagnostic accuracies of conventional and synthetic T 2 W images in staging were also compared. Statistical Tests Parameters were compared using an independent t ‐test, Wilcoxon signed‐rank test, and the chi‐square test. Receiver operating characteristic analysis was performed. Results The T 2 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 mm 2 /s] vs. [0.65 ± 0.11 × 10 −3 mm 2 /s], P  < 0.05) and no difference for LVSI status ([0.71 ± 0.11× 10 −3 mm 2 /s] vs. [0.73 ± 0.12× 10 −3 mm 2 /s], P = 0.472). There was no significant difference in T 2 and ADC values between squamous cell carcinoma and adenocarcinoma ( P = 0.378 and P = 0.661, respectively). In MRI staging, the conventional and synthetic T 2 W images resulted in a similar accuracy (71% vs. 68%, P = 0.698). Data Conclusion The accelerated T 2 mapping sequence may facilitate grading and staging of CC by providing quantitative T 2 maps and synthetic T 2 W images in one acquisition. T 2 values may be superior to ADC in predicting LVSI. Level of Evidence 2 Technical Efficacy Stage 2 J. MAGN. RESON. IMAGING 2020;52:1859–1869.