Sohee Song, Presenter: Nothing to Disclose

Chan Kyo Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Jung Jae Park MD, Abstract Co-Author: Nothing to Disclose

Sung Yoon Park, Abstract Co-Author: Nothing to Disclose

Byung Kwan Park MD, Abstract Co-Author: Nothing to Disclose

Seung Jae Huh PhD, Abstract Co-Author: Nothing to Disclose

To prospectively investigate the value of diffusion-weighted (DWI) and dynamic contrast-enhanced MR imaging (DCEI) as early and reproducible response predictors in cervical cancer patients who received concurrent chemoradiotherapy (CCRT).

Sixteen consecutive patients with biopsy-proven cervical cancer who treated with CCRT were evaluated with MR imaging at 3T, including DWI and DCEI. Four serial MR examinations were performed before CCRT (preTx), after 1 week of therapy (postTx1), after 4 weeks after therapy (postTx2), and after 1 month after the end of therapy (postTx3). At each time point, apparent diffusion coefficient (ADC) and DCEI parameters were calculated in the tumor, gluteus muscle and normal uterus and the results were compared. Tumor response at postTx2 or postTx3, as determined by changes in tumor size or volume using MRI was correlated with tumor ADC or DCEI parameters at preTx and postTx1, or correlated with changes in tumor ADC and DCEI parameters between preTx and postTx1. For reproducibility of ADC and DCEI parameters measurement, 10 patients had two separate pretreatment DWI and DCEI at an interval of < 2 weeks.

At each time point, ADC and DCEI parameters (i.e., Ktrans and Ve) in the tumors showed consecutive increase (all P< 0.05), while those of gluteus muscle and normal uterus did not reveal a significant difference (all P>0.05). At postTx1 tumor ADCs showed a significant correlation with tumor size response at postTx2 (P= 0.003). Changes in tumor ADCs between preTx and postTx1 had a significant correlation with tumor size (P= 0.001) and volume response (P= 0.021) at postTx2. At preTx, tumor Ktrans showed a significant correlation with tumor volume response at postTx3 (P= 0.033); tumor Kep and Ve had a significant correlation with tumor size response at postTx2 (P= 0.043 and P= 0.019, respectively). Reproducibility of ADC versus DCEI parameters measurements in the tumor, gluteus muscle and normal uterus was confirmed with a mean difference of 0.3% versus 0.6%–16.6%, 1.7% versus 0.5%–12.3%, and 2.2% versus 0.9%–17.8% in sequence, respectively.

DWI and DCEI, as early and reproducible biomarkers, have the potential to evaluate therapeutic response to CCRT in patients with cervical cancer.

As imaging biomarkers, ADC and DCEI parameters may aid in the development of more individualized, effective therapy regimens for the patient group.

Song, S, Kim, C, Park, J, Park, S, Park, B, Huh, S, Early Response Assessment to Concurrent Chemoradiotherapy in Cervical Cancer: Value of Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13016310.html