Assessment of early response to concurrent chemoradiotherapy in cervical cancer: value of diffusion-weighted and dynamic contrast-enhanced MR imaging

초록

Purpose: To investigate diffusion-weighted (DWI) and dynamic contrast-enhanced MR imaging (DCE-MRI) as early response predictors in cervical cancer patients who received concurrent chemoradiotherapy (CCRT). Materials and methods: Sixteen patients with cervical cancer underwent DWI and DCE-MRI before CCRT (preTx), at 1 week (postT1) and 4 weeks (postT2) after initiating treatment, and 1 month after the end of treatment (postT3). At each point, apparent diffusion coefficient (ADC) and DCE-MRI parameters were measured in tumors and gluteus muscles (GM). Tumor response was correlated with imaging parameters or changes in imaging parameters at each point. Results: At each point, ADC, K-trans and V-e in tumors showed significant changes (P < 0.05), as compared with those of GM (P> 0.05). PostT1 tumor ADCs showed a significant correlation with tumor size response at postT2 (P = 0.041), and changes in tumor ADCs at postT1 had a significant correlation with tumor size (P = 0.04) and volume response (P = 0.003) at postT2. In tumors, preTx K-trans and V-e showed significant correlations with tumor size at postT3 (P = 0.011) and tumor size response at postT2 (P = 0.019), respectively. Conclusion: DWI and DCE-MRI, as early biomarkers, have the potential to evaluate therapeutic responses to CCRT in cervical cancers. (C) 2014 Elsevier Inc. All rights reserved.

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