title: Accuracy of diffusion-weighted echo-planar MR imaging and ADC mapping in the evaluation of residual cervical carcinoma after radiation therapy.
abstract: OBJECTIVE
  The impact of diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADCs) of MR imaging on the evaluation of residual Uterine Cervical Carcinoma after Radiation Therapy, in addition to conventional MR images.
  
  
  METHODS
  Fourty-nine women presenting with a uterine cervical cancer were examined with 1.5 T MRI and DWI, 8 (4-20) weeks after treatment. Treatment response was determined based on the histopathological results after therapy and was classified as a complete response (CR) or residual disease (RD). Post-treatment DWI and ADC results were compared.
  
  
  RESULTS
  Five (11%) and 44 (89%) patients were considered as having histologically-proven RD or a CR respectively. The mean ADC of cervical tissue for all patients was 1.74±0.324×10(-3) mm(2)/s and the SD was 1.94±1.11×10(-4). The mean ADC was 1.62±0.21×10(-3) mm(2)/s (SD=1.45×10(-4)) for the 5 patients with RD versus 1.76±0.33×10(-3) mm(2)/s (SD=1.99×10(-4)) for the 44 patients with a CR (p=0.09). Using 1.7×10(-3) mm(2)/s as a radiological cut-off value for the ADC, all patients classified as having histologically-proven RD had a mean ADC of ≤1.7×10(-3). In 12 (25%) cases, RD was suspected on T2-weighted MRI images alone. Eight of these cases were considered as false positives compared to the histological results. Their mean ADC was 1.98×10(-3) mm(2)/s and none of them had an ADC of <1.7×10(-3) mm(2)/s.
  
  
  CONCLUSIONS
  Although our results were not statistically significant, ADC values could potentially be used to predict and monitor the response of uterine cervical cancer.
authors.affiliation: Paris XI University, Department of Radiology, Gustave Roussy Institute, Villejuif, France.
authors.forename: Antonin
authors.initials: A
authors.lastname: Levy
authors.forename: Caroline
authors.initials: C
authors.lastname: Caramella
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Aicha
authors.initials: A
authors.lastname: Medjhoul
authors.forename: Annie
authors.initials: A
authors.lastname: Rey
authors.forename: Elise
authors.initials: E
authors.lastname: Zareski
authors.forename: Bérénice
authors.initials: B
authors.lastname: Boulet
authors.forename: François
authors.initials: F
authors.lastname: Bidault
authors.forename: Clarisse
authors.initials: C
authors.lastname: Dromain
authors.forename: Corinne
authors.initials: C
authors.lastname: Balleyguier
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy*