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Purpose <p>To evaluate the added diagnostic value of T2-weighted and diffusion-weighted imaging (DWI) fusion in MRI for detecting metastatic lymph nodes in cervical cancer, and to compare this fusion technique to 18&#xa0;F-FDG PET/CT in terms of sensitivity and specificity.</p> Methods <p>In this retrospective single-center study, 69 patients with histologically confirmed cervical cancer underwent pelvic MRI, including T2-weighted and DWI sequences, as well as 18&#xa0;F-FDG PET/CT. Fusion images combining T2 and high <i>b</i>-value DWI were generated and reviewed by experienced radiologists. The number and location of lymph nodes detected with conventional MRI, fused MRI, and PET/CT were recorded. Statistical analysis was performed using McNemar’s test, with <i>p</i> &lt; 0.05 considered statistically significant.</p> Results <p>Fusion MRI identified additional lymph nodes in 16 of 69 patients (23.2%) that were not detected on MRI alone (<i>p</i> &lt; 0.001). When comparing fusion MRI to PET/CT, 11 (15.9%) patients had lymph nodes detected or more accurately characterized by fusion MRI that PET/CT missed or misinterpreted, while only 1 case (1.4%) was better identified by PET/CT (<i>p</i> = 0.006).</p> Conclusion <p>Fusion of T2-weighted and DWI MRI sequences improves the detection and characterization of metastatic lymph nodes in cervical cancer staging, surpassing both standard MRI and PET/CT in selected cases. This technique offers a non-invasive, accessible, and efficient enhancement to conventional imaging protocols, with the potential to influence treatment planning and improve patient outcomes.</p>

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Evaluating lymph node metastases in cervical cancer: the added value of T2/DWI MRI fusion compared to standard MRI alone and 18 F-FDG PET/CT

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Joana Paiva Santos,
  • Rita Prata,
  • Maria Ana Serrado,
  • Teresa Margarida Cunha

摘要

Purpose

To evaluate the added diagnostic value of T2-weighted and diffusion-weighted imaging (DWI) fusion in MRI for detecting metastatic lymph nodes in cervical cancer, and to compare this fusion technique to 18 F-FDG PET/CT in terms of sensitivity and specificity.

Methods

In this retrospective single-center study, 69 patients with histologically confirmed cervical cancer underwent pelvic MRI, including T2-weighted and DWI sequences, as well as 18 F-FDG PET/CT. Fusion images combining T2 and high b-value DWI were generated and reviewed by experienced radiologists. The number and location of lymph nodes detected with conventional MRI, fused MRI, and PET/CT were recorded. Statistical analysis was performed using McNemar’s test, with p < 0.05 considered statistically significant.

Results

Fusion MRI identified additional lymph nodes in 16 of 69 patients (23.2%) that were not detected on MRI alone (p < 0.001). When comparing fusion MRI to PET/CT, 11 (15.9%) patients had lymph nodes detected or more accurately characterized by fusion MRI that PET/CT missed or misinterpreted, while only 1 case (1.4%) was better identified by PET/CT (p = 0.006).

Conclusion

Fusion of T2-weighted and DWI MRI sequences improves the detection and characterization of metastatic lymph nodes in cervical cancer staging, surpassing both standard MRI and PET/CT in selected cases. This technique offers a non-invasive, accessible, and efficient enhancement to conventional imaging protocols, with the potential to influence treatment planning and improve patient outcomes.