Hyun Su Kim, Presenter: Nothing to Disclose

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

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

Bohyun Kim MD, Abstract Co-Author: Nothing to Disclose

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

To prospectively investigate the changes of apparent diffusion coefficient (ADC) in cervical cancer patients receiving concurrent chemoradiotherapy (CCRT), and to assess the relationship between tumor ADC or changes in tumor ADC and final tumor responses to treatment.

24 consecutive patients (mean age, 57.3 years) with biopsy-proven cervical cancer were examined by T2-weighted (T2WI) and diffusion-weighted (DW) imaging at 3T using a phased-array coil. DW images were obtained using a STIR single-shot echo-planar imaging technique with background suppression. All patients who treated with CCRT performed three serial MR examinations [i.e., prior to therapy (pre-Tx), at the fourth week of therapy (mid-Tx), and 1 month after the completion of therapy (post-TxT)]. At each therapeutic point, ADC was calculated in the tumors and normal gluteus muscles (as a standard reference) by an experienced radiologist and the results were compared. Final tumor responses as determined by changes in tumor size or volume using MRI {(pre-Tx - post-Tx)/pre-Tx} was correlated with tumor ADC at each therapeutic point or changes in tumor ADC between pre-Tx and mid-Tx or post-Tx.

The mean ADC of the tumors was 0.88 at pre-Tx, 1.30 at mid-Tx, and 1.47 × 10-3/mm2/s at post-Tx, respectively, which showed a significant difference (P< 0.001). However, the mean ADC of normal gluteus muscles had 1.24 at pre-Tx, 1.29 at mid-Tx, and 1.21 × 10-3/mm2/s at post-Tx, respectively, which did not show a significant difference (P= 0.53). At mid-Tx, tumor ADC showed a significant correlation with final tumor size response (P= 0.029, Spearman’s coefficient= 0.457). Changes in tumor ADC between pre-Tx and mid-Tx had a significant correlation with final tumor size response (P= 0.025, Spearman’s coefficient= 0.467). However, tumor ADC at pre-Tx or changes in tumor ADC between pre-Tx and post-Tx was not associated with final tumor size response. Final tumor volume response was not associated with tumor ADC or changes in tumor ADC.

The ADC value in cervical cancer was consecutively increased before, during and after therapy. At mid-Tx, tumor ADC or changes in tumor ADC showed a positive relation with the final tumor size response. 

The ADC may help to monitor therapeutic response of cervical cancer to CCRT. As an imaging biomarker, the ADC may play an important role in the development of a personalized treatment.

Kim, H, Kim, C, Park, B, Kim, B, Huh, S, Evaluation of Therapeutic Response to Concurrent Chemoradiotherapy in Cervical Cancer: Value of Apparent Diffusion Coefficient.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002356.html