Predicting and Early Monitoring Treatment Efficiency of Cervical Cancer Under Concurrent Chemoradiotherapy by Intravoxel Incoherent Motion Magnetic Resonance Imaging.
OBJECTIVE
The aim of this study was to explore the potential of intravoxel incoherent motion magnetic resonance (MR) imaging in predicting and measuring responses to concurrent chemoradiotherapy (CCRT) in advanced cervical cancers.


METHODS
Thirty-seven patients with advanced cervical cancers scheduled for CCRT underwent MR examinations including intravoxel incoherent motion sequence with 9 b values (0-800 s/mm) before CCRT, 2 and 4 weeks after the initiation of CCRT, and immediately after CCRT. Apparent diffusion coefficient, f, D, and D* values were obtained during the course. The maximum diameter of the tumor was measured to determine the treatment efficiency.


RESULTS
At the end of CCRT, 25 patients were classified as complete response and 12 as partial response. The pretreatment f of cervical cancer showed its efficiency in predicting partial response and complete response with an area under receiver operating characteristic curve of 0.768. During CCRT, the apparent diffusion coefficient, D, and D* values kept on rising, whereas f increased first and then decreased after 4 weeks of CCRT.


CONCLUSIONS
Intravoxel incoherent motion MR imaging held great potential in both predicting and early monitoring treatment efficiency of advanced cervical cancer under CCRT.
From the *Department of Radiology, Nanjing Drum Tower Hospital, and †The Comprehensive Cancer Centre of Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing; and ‡Philips Healthcare, Shanghai, China; and §Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA.
Li
L
Zhu
Lijing
L
Zhu
Huanhuan
H
Wang
Jing
J
Yan
Baorui
B
Liu
Weibo
W
Chen
Jian
J
He
Zhengyang
Z
Zhou
Xiaofeng
X
Yang
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002584:Cervix Uteri / Q000000981:diagnostic imaging; D059248:Chemoradiotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009038:Motion; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D055815:Young Adult