Combined dynamic DCE-MRI and diffusion-weighted imaging to evaluate the effect of neoadjuvant chemotherapy in cervical cancer. Issue 2 (April 2020)

• Record Type: Journal Article
• Authors: Feng, Yusen; Liu, Hui; Ding, Yingying; Zhang, Ya; Liao, Chengde; Jin, Yan; Ai, Conghui
• Is Part Of: Tumori. Volume 106:Issue 2(2020)
• Page Start: 155
• Page End: 164
• Publication Date: 2020-04
• Subjects: Uterine cervical neoplasms -- magnetic resonance imaging -- diffusion magnetic resonance imaging -- neoadjuvant chemotherapy -- functional MRI; Cancer -- Periodicals; 616.994
• DOI: 10.1177/0300891619886656
• Languages: English
• ISSNs: 0300-8916

Abstract

Purpose: To prospectively investigate changes in quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in patients with cervical cancer before and after neoadjuvant chemotherapy (NACT). Methods: Thirty-eight patients with cervical cancer underwent DCE-MRI and DWI 1 week before and 4 weeks after NACT. The patients were classified into 2 groups: significant reaction (sCR) group and the non-sCR group. DCE-MRI parameters and ADC values were measured and compared between the 2 groups. Results: Before NACT, the mean K trans value was higher, but the mean Ve was lower, in the sCR group compared with the non-sCR group; these differences were statistically significant ( p <0.05). After NACT, the mean K trans value and the delta (i.e., changed) value of K trans were significantly lower in the sCR group compared with the non-sCR group ( p <0.05). However, the mean ADC and the delta value of the mean ADC between the 2 groups were slightly higher in the sCR group compared with the non-sCR group ( p <0.05). The area under the curve of pre-mean K trans, DK trans, and pre-mean K trans combined with post-mean ADC values were 0.801, 0.955, and 0.878, respectively ( p <0.05). The optimal cutoff values for distinguishing sCR from non-sCR were pretreatment K trans (0.7020 min −1 ) and DK trans (0.0437 min −1 ). Conclusions: Quantitative parameters (pre-mean K trans, DK trans, and pre-mean K trans ) combined with post-mean ADC could predict treatment efficacy more precisely. However, quantitative DCE-MRI combined with DWI could not significantly improve prognostic efficacy.