The Application of Time-Dependent Diffusion MRI in Clinical Staging and Pathological Differentiation of Cervical Squamous Carcinoma

Motivation: Time-dependent diffusion magnetic resonance imaging (TDD-MRI) remains underexplored in the clinical staging and differentiation of cervical squamous carcinoma (CSC). Goal(s): To compare the diagnostic accuracy of TDD-MRI microstructural parameters with conventional apparent diffusion coefficient (ADC) values in the staging and differentiation of CSC. Approach: TDD-MRI derived microstructural parameters-cell diameter (d), intracellular volume frac-tion (vin), extracellular diffusion coefficient (Dex), and ADC values were measured. Early-stage and mid-to-late-stage groups, poorly differentiated and moderately to well-differentiated groups were divided and compared. Results: TDD-MRI parameters outperformed ADC in differentiating CSC. Combined TDD-MRI and ADC values achieved an AUC of 0.85, showing a significant improvement over ADC alone. Impact: TDD-MRI parameters, particularly cell diameter, demonstrate superior accuracy to ADC in differentiating pathological grades and stages in CSC, supporting their use for non-invasive cervical cancer assessment.