Characterising heterogeneity of stage 1 cervical cancers using histogram analysis from diffusion weighted images.

Introduction: Prognosis of patients with stage 1 cervical cancer is dependent on primary tumor histology: adenocarcinoma tumour types, poorlydifferentiated tumours and those with invasion of the microvasculature have a higher incidence of metastases and therefore a poorer prognosis than their squamous cell, well-differentiated counterparts with no evidence of lymphovascular space invasion (LVSI). Apparent Diffusion Coefficient (ADC) values in cervical cancer have been shown to be significantly lower than non-malignant cervical epithelium and cervical intraepithelial neoplasia and a mean tumour ADC has shown potential as predictive biomarker. This study aims to use histogram analysis to establish whether ADC values are significantly different in cervical tumours according to their histological characteristics.