Application Of Diffusion-relaxation Correlation Spectrum Imaging And IVIM Model In Staging Diagnosis Of Cervical Squamous Cell Carcinoma

Objective:To evaluate the diagnostic value of diffusion-relaxation correlation spectrum imaging（DR-CSI）and intravoxel incoherent motion（IVIM）model in clinical staging of cervical squamous cell carcinoma.Materials and Methods:A total of 60 patients with cervical squamous cell carcinoma confirmed by pathological biopsy were divided into an early group and an advanced group according to the international federation of gynecology and obstetrics（FIGO）2018 staging criteria.Routine T2 weighted imaging（T2WI）,IVIM sequence,and DR-CSI sequence were performed before operation.The DR-CSI sequence was obtained to construct the diffusion-relaxation correlation spectrum（T2-D spectrum）,and the T2-D spectrum was divided into six microscopic compartments.The DR-CSI sequence parameters:apparent diffusion coefficient（ADC）,transverse relaxation time（T2）,the fraction of each microscopic compartment（f）,and IVIM sequence parameters:diffusion coefficient（D）,perfusion-related diffusion coefficient（D*）and perfusion fraction（F）were measured for the region of interest（ROI）,and the differences in parameters between the two groups were compared using two independent samples t-test or Mann-Whitney U-test.Binary Logistic regression analysis was used for multi-parameter joint analysis and receiver operating characteristics（ROC）analysis to evaluate each parameter’s diagnostic efficiency and their combinations in distinguishing early from advanced cervical squamous cell carcinoma.The De Long test was used to compare the significant differences between each parameter the area under the curve（AUC）and their combinations.Results:ADC,D,and f _D in advanced cervical squamous cell carcinoma were significantly lower than those in early cervical squamous cell carcinoma,while f _B was significantly higher than that in early cervical squamous cell carcinoma.There were significant differences in ADC,D,f _D,and f _B in differentiating early and advanced cervical cancer（P<0.05）.There was no significant difference in other parameters between early and advanced cervical squamous cell carcinoma.Among the single parameters,f _D had the highest diagnostic efficiency（AUC=0.827）,followed by D and f _B,with AUC of 0.769and 0.729,respectively.The best diagnostic critical value of f _D,D,and f _B is 0.090×10^-3mm²/s,0.903×10^-3 mm²/s,0.570.Among the multi-parameter combined diagnosis,the diagnostic efficiency of the DR-CSI six-compartment combination（f _A-f _F）was the highest,with an AUC of 0.889,which was higher than that of IVIM model（D,D*,F）（AUC=0.729）,and significantly better than that of ADC combined with T2（AUC=0.700）.Conclusion:Parameters of the DR-CSI model and IVIM model:ADC,D,f _D,and f _B can quantitatively distinguish early and advanced cervical squamous cell carcinoma.The f _Dand six-compartment combination（f _A-f _F）in the DR-CSI model has the highest diagnostic efficiency.Compared with traditional T2 mapping,ADC model,and IVIM model,DR-CSI has a higher value in differentiating early and advanced cervical squamous cell carcinoma.