title: Predictive value of diffusion-weighted magnetic resonance imaging during chemoradiotherapy for uterine cervical cancer.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of diffusion-weighted (DW) magnetic resonance (MR) imaging to predict the tumor response to chemoradiotherapy (CRT) of uterine cervical cancer.
  
  
  METHODS
  Twenty-five consecutive patients with pathologically confirmed uterine cervical cancer underwent 1.5-T MR imaging including DW imaging before and during CRT. MR images were reviewed for the size and apparent diffusion coefficient (ADC). Pathological evaluation of the therapeutic effect was performed 3 months after finishing CRT, and we divided the subjects into two groups: complete remission (CR) (n=16) and residual tumor (n=9).
  
  
  RESULTS
  ADC was lower before CRT than during CRT (0.89 ± 0.12 and 1.25 ± 0.22 × 10⁻³ mm²/s, respectively) (P<0.01). ADC change between before and during CRT (ΔADC) showed a moderate positive correlation (r=0.435, P<0.05) with the tumor regression rates. ΔADC was higher in the CR group than in the residual tumor group (0.43 ± 0.23 and 0.25 ± 0.15 × 10⁻³ mm²/s, respectively) (P<0.05). The CR rates were higher in the high ΔADC group (ΔADC  ≥ 0.50) than in the low ΔADC group (ΔADC <0.49) (100% and 53%, respectively) but marginally significant (P=0.057). The local control rates were not statistically different between high and low ΔADC groups (83.3% and 73.7%, respectively) (P=0.602).
  
  
  CONCLUSIONS
  DW imaging including ADC measurement may be useful for prediction and early assessment of pathological response to CRT for uterine cervical cancer, but its impact on local disease-free survival was limited.
authors: Department of Obstetrics and Gynecology, Gifu University Hospital, Gifu, Japan.
authors: Hiroshi
authors: H
authors: Makino
authors: Hiroki
authors: H
authors: Kato
authors: Tatsuro
authors: T
authors: Furui
authors: Ken-ichirou
authors: K
authors: Morishige
authors: Masayuki
authors: M
authors: Kanematsu
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D002584:Cervix Uteri / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D059248:Chemoradiotherapy; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*
chemical_list: D015415:Biomarkers
keywords: chemoradiotherapy; diffusion-weighted imaging; magnetic resonance imaging; treatment response; uterine cervical cancer