European Radiology

, Volume 28, Issue 5, pp 1875–1883 | Cite as

Intravoxel incoherent motion MR imaging of early cervical carcinoma: correlation between imaging parameters and tumor-stroma ratio

  • Xiangsheng Li
  • Ping Wang
  • Dechang Li
  • Hongxian Zhu
  • Limin Meng
  • Yunlong Song
  • Lizhi Xie
  • Jianping Zhu
  • Tao YuEmail author
Magnetic Resonance



To investigate if intravoxel incoherent motion (IVIM) MR imaging can predict the tumour-stroma ratio (TSR) in patients with early cervical carcinoma.


Fifty-four patients with early cervical carcinoma were prospectively enrolled into this study. All patients underwent IVIM imaging and parameters including D, D* and f value were measured. The tumours were classified into stroma-rich and stroma-poor group according to TSR, and comparisons of IVIM parameters between two groups were performed. The relationships between IVIM parameters and TSR were analysed by using a multivariate multi-regression analysis.


D and f values were significantly lower in stroma-poor tumours than in stroma-rich tumours (p=0.02, 0.04), while the difference in D* value between two groups didn't achieve statistical significance (p=0.09). The areas under ROC curves of D and f values in discriminating stroma-rich and stroma-poor tumours were 0.835 (95%CI=0.616~0.905) and 0.686 (95%CI=0.575~0.798). In multiple linear regression analysis, D value, pathologic type, histologic grade, tumour size and f value were independently correlated with TSR of cervical carcinoma.


D and f values are independently correlated with TSR of cervical carcinoma and have the potential for quantitative measurement of TSR.

Key Points

TSR is a recognized independent prognostic factor in many solid tumours.

D and f values measured by IVIM MRI are independently correlated with TSR while D* is not.

IVIM offers the potential to predict TSR.


Diffusion Magnetic Resonance Imaging Uterine Cervical Neoplasms Stromal Cells Intravoxel incoherent motion Tumor-stroma ratio 



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Li Xiang Sheng, M.D. and Yu Tao, M.D.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• Prospective

• diagnostic study / observational

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Xiangsheng Li
    • 1
  • Ping Wang
    • 1
  • Dechang Li
    • 2
  • Hongxian Zhu
    • 1
  • Limin Meng
    • 1
  • Yunlong Song
    • 1
  • Lizhi Xie
    • 3
  • Jianping Zhu
    • 2
  • Tao Yu
    • 4
    Email author
  1. 1.Department of RadiologyAir Force General Hospital, People’s Liberation ArmyBeijingChina
  2. 2.Department of PathologyAir Force General Hospital, People’s Liberation ArmyBeijingChina
  3. 3.Department of MR ResearchGE HealthcareBeijingChina
  4. 4.Department of Medical ImagingCancer Hospital of China Medical University & Liaoning Cancer Hospital & InstituteShenyangPeople’s Republic of China

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