Early diffusion weighted magnetic resonance imaging can predict survival in women with locally advanced cancer of the cervix treated with combined chemo-radiation.
OBJECTIVE
To assess the predictive value of diffusion weighted imaging (DWI) for survival in women treated for advanced cancer of the cervix with concurrent chemo-radiotherapy.


METHODS
Twenty women treated for advanced cancer of the cervix were recruited and followed up for a median of 26 (range <1 to 43) months. They each had DWI performed before treatment, 2 weeks after beginning therapy (midtreatment) and at the end of treatment. Apparent diffusion coefficient (ADC) values were calculated from regions of interest (ROI). All participants were reviewed for follow-up data. ADC values were compared with mortality status (Mann-Whitney test). Time to progression and overall survival were assessed (Kaplan-Meier survival graphs).


RESULTS
There were 14 survivors. The median midtreatment ADC was statistically significantly higher in those alive compared to the non-survivors, 1.55 and 1.36 (×10(-3)/mm(2)/s), respectively, P = 0.02. The median change in ADC 14 days after treatment commencement was significantly higher in the alive group compared to non-survivors, 0.28 and 0.14 (×10(-3)/mm(2)/s), respectively, P = 0.02. There was no evidence of a difference between survivors and non-survivors for pretreatment baseline or post-therapy ADC values.


CONCLUSIONS
Functional DWI early in the treatment of advanced cancer of the cervix may provide useful information in predicting survival.


CONCLUSIONS
• Diffusion weighted magnetic resonance imaging (DWI) is increasingly used in cervical cancer.                                  • Functional DWI early in treatment of cervical cancer may help predict survival.                                  • DWI may help clinicians to tailor or individualise treatment appropriately.                                  • This may limit toxicity from ineffective treatment and allow early alternative therapy.
Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, UK. g.somoye@nhs.net
Gbolahan
G
Somoye
Vanessa
V
Harry
Scott
S
Semple
George
G
Plataniotis
Neil
N
Scott
Fiona J
FJ
Gilbert
David
D
Parkin
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D059248:Chemoradiotherapy / Q000379:methods*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*