Combined dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging to predict neoadjuvant chemotherapy effect in FIGO stage IB2-IIA2 cervical cancers

Purpose To explore the value of histogram analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters and apparent diffusion coefficient (ADC) values in predicting the neoadjuvant chemotherapy (NACT) response for cervical cancers. Methods Sixty-three patients with pathologically proved stage IB2-IIA2 cervical cancer from March 2013 to January 2017 were retrospectively analyzed. They were divided into two groups on the basis of therapeutic response: the significant response (SR) group, which contains complete response patients and partial response patients, and nonsignificant response (non-SR) group, which contains progressive diseases and stable diseases. Clinical characteristics, DCE-MRI parameters (K-trans, K-ep, V-e), and ADC values before NACT were analyzed and compared between the two groups. Results SR group and non-SR group were documented in 35 and 28 patients. The mean K-trans value, 90th percentile K-trans value, maximal K-trans value, and 90th percentile ADC value of tumors in SR were significantly higher than those in non-SR group (P = 0.012, P = 0.022, P = 0.005, P = 0.033, respectively), and the mean V-e value and 10th percentile V-e value of tumors were significantly lower in SR group (P = 0.041, P = 0.033, respectively). K-ep values did not significantly differ between SR and non-SR. The 90th percentile K-trans value combined with the 90th percentile ADC value had the highest area under the curve at 0.740 (P = 0.003) to predict NACT effectiveness. Conclusion Histogram analysis of DCE-MRI multi-parameters combined with ADC values may serve as sensitive indicators for predicting NACT effectiveness in cervical cancers.