Abstract
INTRODUCTION: The apparent diffusion coefficient (ADC) is a significant parameter in the diagnosis and monitoring of cervical cancer. The aim of this study is to evaluate ADC values in patients with cervical cancer, post-therapeutic changes, and normal findings, in order to assess their association with clinicopathological parameters, predict therapeutic outcomes, and differentiate residual tumors from post-treatment tissue without residual disease. METHODS: A retrospective study included 148 patients divided into three groups: cervical cancer, post-therapeutic changes and normal findings. ADC values were measured by positioning ROI in the target tissue. Statistical analyses included ANOVA, t-tests, and ROC analysis. RESULTS: The mean ADC values for cervical cancer (0.798 × 10(-3) mm(2)/s) were significantly lower compared to post-therapeutic changes (1.394 × 10(-3) mm(2)/s) and normal findings (1.431 × 10(-3) mm(2)/s; p < 0.001). ADC values did not show statistically significant differences based on clinicopathological parameters. The change in ADC values after therapy (ΔADC: 0.607 × 10(-3) mm(2)/s) indicated reduced cellularity. The mean ADC values of residual tumors (1.299 × 10(-3) mm(2)/s) were significantly lower compared to post-therapeutic tissue without residual tumors (1.472 × 10(-3) mm(2)/s; p = 0.029). The optimal value for distinguishing residual tumors from post-therapeutic tissue without residual tumors was 1.436 × 10(-3) mm(2)/s. The optimal value for differentiating pre- and post-therapeutic tumor tissue was 0.929 × 10(-3) mm(2)/s. DISCUSSION: ADC proved to be a reliable imaging biomarker for differentiating cervical cancer, post-therapeutic changes, and normal findings, as well as for assessing therapeutic response. It demonstrated significant potential in distinguishing residual tumor tissue from post-treatment changes without residual disease.