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Volume 133, Issue 2, Pages 326-332 (May 2014) Preoperative imaging in patients undergoing trachelectomy for cervical cancer: Validation of a combined T2- and diffusion-weighted endovaginal MRI technique at 3.0T Katherine Downey, John H. Shepherd, Ayoma D. Attygalle, Steve Hazell, Veronica A. Morgan, Sharon L. Giles, Thomas E.J. Ind, Nandita M. deSouza Gynecologic Oncology Volume 133, Issue 2, Pages 326-332 (May 2014) DOI: 10.1016/j.ygyno.2014.02.026 Copyright © 2014 The Authors Terms and Conditions

Fig. 1 Coronal T2-W (left), and corresponding b-800s/mm2 (middle) and ADC map (right) slices showing a small tumour on the left cervical lip (arrows). Gynecologic Oncology 2014 133, 326-332DOI: (10.1016/j.ygyno.2014.02.026) Copyright © 2014 The Authors Terms and Conditions

Fig. 2 Measuring length of normal endocervical canal above tumour on sagittal T2-W images (left) with sagittal ADC maps (right) for reference. Tumour is seen an intermediate signal-intensity mass in A and an area of restricted diffusion on the ADC map (arrows). Gynecologic Oncology 2014 133, 326-332DOI: (10.1016/j.ygyno.2014.02.026) Copyright © 2014 The Authors Terms and Conditions

Fig. 3 Assessing tumour volume on histology. Coronal T2-W (top left), b-800s/mm2 diffusion-weighted (top middle) and ADC map (top right) images through the mid cervix. Tumour is outlined in T2-W with reference to diffusion-weighted images (arrow). The trachelectomy specimen with the tumour delineated (bottom left) is photographed with an overlying millimetre grid (bottom right) and the area in mm2 calculated. Gynecologic Oncology 2014 133, 326-332DOI: (10.1016/j.ygyno.2014.02.026) Copyright © 2014 The Authors Terms and Conditions

Fig. 4 Transverse T2-W (top left), b-800s/mm2 (top right) and ADC map (bottom left) showing a small tumour in the posterior endocervix (arrows) that correlates with that shown on the trachelectomy specimen (bottom right). Gynecologic Oncology 2014 133, 326-332DOI: (10.1016/j.ygyno.2014.02.026) Copyright © 2014 The Authors Terms and Conditions

Fig. 5 Bland–Altman plots of variability in assessment of maximal tumour dimension between observers (left), between observer 1 and histology (middle) and between observer 2 and histology (right). Dashed lines show the limits of agreement (95% confidence intervals). Gynecologic Oncology 2014 133, 326-332DOI: (10.1016/j.ygyno.2014.02.026) Copyright © 2014 The Authors Terms and Conditions

Fig. 6 Bland–Altman plots of variability in assessment of tumour volume between observers (left), between observer 1 and histology (middle) and between observer 2 and histology (right). Dashed lines show the limits of agreement (95% confidence intervals). Gynecologic Oncology 2014 133, 326-332DOI: (10.1016/j.ygyno.2014.02.026) Copyright © 2014 The Authors Terms and Conditions