Diffusion-weighted imaging in predicting and monitoring the response of uterine cervical cancer to combined chemoradiation

AIM: To investigate the ability of diffusion-weighted imaging (DWI) to predict and monitor the response of uterine cervical cancer to combined chemoradiation using apparent diffusion coefficients (ADCs). MATERIALS AND METHODS: Seventeen women (mean age 48.5 years) with uterine cervical cancer received conventional magnetic resonance imaging (MRI) and DWI prior to chemoradiation and after 1 and 2 months of therapy. A subgroup of eight also had MRI and DWI repeated after 15 days of therapy. Treatment response was determined according to changes in tumour size after 2 months of therapy and was classified as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Pretreatment ADCs were compared between the different disease response groups, and dynamic changes of ADCs in each group were observed. Pearson's correlation test was calculated between those ADC parameters and tumour response. RESULTS: Pretreatment ADCs for CR were significantly lower than those of PR (p = 0.005). Negative correlation was found between pretreatment ADCs and percentage size reduction after 2 months of chemoradiation (p = 0.016). The percentage ADC change after I month correlated positively with percentage size reduction after 2 months of therapy (p = 0.021). ADCs after 15 days of therapy increased significantly compared with pretreatment ones (p = 0.001); however, the longest tumour diameter showed no statistically significant change (p = 0.078). CONCLUSION: ADCs may have the potential to be used to predict and monitor the response of uterine cervical cancer to therapy. (C) 2009 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.