Jung Jae Park MD, Presenter: Nothing to Disclose

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

Jungmin Bae, Abstract Co-Author: Nothing to Disclose

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

To retrospectively investigate the utility of diffusion-weighted imaging (DWI) for the prediction of tumor recurrence following concurrent chemoradiotherapy (CCRT) in patients with uterine cervical cancer.

Between April 2009 and February 2014, 74 consecutive patients (mean age, 62.9 years; range, 32–87 years) with biopsy-proven cervical cancer who received CCRT were examined with 3T pelvis MR imaging including DWI. DWI was obtained using a STIR single-shot echo-planar imaging technique with background body signal suppression (b= 0 and 1000 s/mm2). All patients had two serial MR examinations: before therapy (pre-Tx) and at 4 weeks of therapy (mid-Tx). At each examination, ADC (apparent diffusion coefficient) was calculated in the tumors. For predicting tumor recurrence, MR variables (baseline tumor ADC, tumor ADC changes, tumor size and volume, tumor size and volume changes) and clinical variables (age, FIGO stage, serum squamous cell antigen level, and histological type) were evaluated.

During a median follow-up of 31.5 months, tumor recurrence developed in 15 (20%) patients: local recurrence (n= 7), distant metastasis (n= 5) and local recurrence and distant metastasis (n= 3). Univariate Cox analysis revealed that histological types, baseline tumor size and volume, tumor size changes between pre-Tx and mid-Tx, and tumor ADC changes between pre-Tx and mid-Tx were significantly related to the development of tumor recurrence following CCRT(P< 0.05). On multivariate Cox analysis, however, tumor ADC changes between pre-Tx and mid-Tx (hazard ratio [HR], 0.839; P = 0.001) and histological type (HR, 7.213; P= 0.033) were the significant independent predictors of tumor recurrence following CCRT.

Tumor ADC changes between pre-Tx and mid-Tx may be a useful clinical prognostic biomarker for the prediction of cervical cancer recurrence following CCRT.

Tumor ADC changes before and after CCRT may help to predict therapeutic outcomes of cervical cancer. As an imaging biomarker, the ADC may play an important role in the development of an individualized treatment.

Park, J, Kim, C, Bae, J, Park, B, Prediction of Tumor Recurrence in Uterine Cervical Cancer Following Concurrent Chemoradiotherapy Using Diffusion-Weighted Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012859.html