Background: Further research into further diagnostic techniques for tumor histological type seems crucial because the histology of the tumor may have a substantial impact on the treatment plan and surgical strategy selected. This study investigated adding values of diffusion weighted imaging with background signal suppression (DWIBS) Sequence to the conventional MRI protocol in assessment and loco-regional staging of different gynecological tumors.

Methods: This study included 55 patients with a confirmed diagnosis of any gynecologic neoplasm with preoperative staging by the conventional MRI and DWIBS with high b value (1500 s/mm2).

Results: examined 55 Patients were divided according to final histopathological diagnosis into ovarian, cervical, endometrial and vulvar tumors. in conventional DWI, there was overlap as regard borderline ovarian tumors that shows false restriction, with significant difference between the conventional DWI results in early stages of Figo staging system (stage IB and IIA P=0.031 and 0.016 respectively), while DWIBS shows accurate assessment of borderline ovarian tumors and early stages of Figo staging system with no-significant difference between it and the histopathological results (p<0.05).

Conclusion: DWIBS can support and boost the accuracy of MRI in identifying or ruling out possible malignancy in gynecological malignancies. DWIBS is useful in detection of borderline ovarian tumors that is not restricted at DWIBS and falsely restricted in the conventional DWI, also DWI plays an important role in loco-regional staging of gynecological tumors especially at early stages and that would enable strategies to retain fertility in young women and limit unwanted radiation.