title: Evaluating early response of cervical cancer under concurrent chemo-radiotherapy by intravoxel incoherent motion MR imaging.
abstract: BACKGROUND
  Intravoxel incoherent motion (IVIM) MR imaging has been applied in researches of various diseases, however its potential in cervical cancer patients has not been fully explored. The purpose of this study was to investigate the feasibility of IVIM MR imaging to monitor early treatment response in patients receiving concurrent chemo-radiotherapy (CCRT) for advanced cervical cancers.
  
  
  METHODS
  Twenty-one patients receiving CCRT for advanced cervical cancer were prospectively enrolled. MR examinations including IVIM imaging (with 14 b values, 0 ~ 1000 s/mm(2)) were performed at 4 time points: 1-week prior to, 2-week and 4-week during, as well as immediately post CCRT (within 1 week). The apparent diffusion coefficient (ADC) maps were derived from the mono-exponential model, while the diffusion coefficient (D), perfusion fraction (f) and pseudo-diffusion coefficient (D*) maps were calculated from the bi-exponential model. Dynamic changes of ADC, D, f and D* in cervical cancers were investigated as early surrogate markers for treatment response.
  
  
  RESULTS
  ADC and D values increased throughout the CCRT course. Both f and D* increased in the first 2 to 3 weeks of CCRT and started to decrease around 4 weeks of CCRT. Significant increase of f value was observed from prior to CCRT (f 1 = 0.12 ± 0.52) to two-week during CCRT (f2 = 0.20 ± 0.90, p = 0.002).
  
  
  CONCLUSIONS
  IVIM MR imaging has the potential in monitoring early tumor response induced by CCRT in patients with cervical cancers.
authors: Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. zhuli-nju@hotmail.com.
authors: Li
authors: L
authors: Zhu
authors: The Comprehensive Cancer Centre of Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. zhulj@hotmail.com.
authors: Lijing
authors: L
authors: Zhu
authors: Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. shihuabella@126.com.
authors: Hua
authors: H
authors: Shi
authors: Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. 18205188503@126.com.
authors: Huanhuan
authors: H
authors: Wang
authors: The Comprehensive Cancer Centre of Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. firefreebird@163.com.
authors: Jing
authors: J
authors: Yan
authors: The Comprehensive Cancer Centre of Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. baoruiliu@nju.edu.cn.
authors: Baorui
authors: B
authors: Liu
authors: Philips Healthcare, Shanghai, China. Weibo.Chen@philips.com.
authors: Weibo
authors: W
authors: Chen
authors: Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. hjxueren@126.com.
authors: Jian
authors: J
authors: He
authors: Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China. zyzhou@nju.edu.cn.
authors: Zhengyang
authors: Z
authors: Zhou
authors: Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA. Xiaofeng.yang@emory.edu.
authors: Xiaofeng
authors: X
authors: Yang
authors: Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA. tliu34@emory.edu.
authors: Tian
authors: T
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy / Q000379:methods*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*