Relationship between intravoxel incoherent motion diffusion-weighted MRI and dynamic contrast-enhanced MRI in tissue perfusion of cervical cancers

Purpose To investigate the relationship between intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) and dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer perfusion. Materials and Methods Prospective newly diagnosed cervical cancer patients underwent diffusion-weighted MRI (13 b-values: 1-1000 s/mm²) and DCE-MRI. The IVIM perfusion parameters, perfusion fraction (f), pseudodiffusion coefficient (D∗), and flow-related parameter (fD∗), were derived from a biexponential decay model. DCE-MRI was analyzed with a pharmacokinetic model and signal-time curve to derive the amplitude factor (A), estimated volume transfer constant between blood plasma, and the extravascular extracellular space (_estK^trans), maximum relative enhancement (MaxRE), and area under the signal-time curve (AUC). Spearman's rank correlation coefficient (r) evaluated the correlative relationships. Results The f = 13.51%-±-1.76%, D∗ = 71.72-±-7.55 × 10^-3 mm²/s, fD∗ = 9.64-±-1.28 × 10^-3 mm²/s, A = 1.41-±-0.43, _estK^trans = 0.19-±-0.06 s^-1, MaxRE of 120.02-±-21.07%, and AUC 212,393-±-54,423 was found in 25 cervical cancer patients. Statistically significant positive correlations were found between fD∗ and _estK^trans (r = 0.42, P = 0.038), fD∗ and A (r = 0.50, P = 0.011), fD∗ and MaxRE (r = 0.52, P = 0.008), f and AUC (r = 0.58, P = 0.003). Conclusion: The IVIM perfusion parameters showed moderate to good correlations with quantitative and semiquantitative perfusion parameters derived from DCE-MRI in cervical cancer.