Department of Gynecology and Obstetrics, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Int J Gynecol Cancer. 2012 Jul;22(6):1037-43. doi: 10.1097/IGC.0b013e31825736d7.
The objective of this study was to investigate whether magnetic resonance diffusion-weighted imaging (DWI) of locally advanced cervical cancer (LACC) both in the sagittal and axial planes could be used to assess the response of LACC to neoadjuvant chemotherapy (NACT).
Thirty women with LACC received conventional magnetic resonance imaging and DWI at 3 different times (before NACT, 2 weeks after the first NACT, and 2 weeks after the second NACT). Treatment response was determined according to the change in tumor size 2 weeks after the second NACT, and they were classified as the effective group and the ineffective group. The apparent diffusion coefficients (ADCs) were compared between 2 imaging planes, and dynamic changes in ADCs were observed in different chemotherapy-sensitive groups and imaging planes. One-way analysis of variance was calculated between those ADC parameters and tumor response.
The effective chemotherapy rate was 76.67%. Apparent diffusion coefficient values of the axial plane at 3 different times were 0.88 (SD, 0.08) × 10⁻³ mm²/s, 0.96 (SD, 0.10) × 10⁻³ mm²/s, and 1.19 (SD, 0.11) × 10⁻³ mm²/s, respectively. Meanwhile, ADC values of the sagittal planes were 0.89 (SD, 0.09) × 10⁻³ mm²/s, 0.97 (SD, 0.12) × 10⁻³ mm²/s, and 1.19 (SD, 0.12) × 10⁻³ mm²/s at 3 different stages. There were no statistical differences between the ADC values of the 2 planes at 3 different times (P = 0.927, P = 0.863, P = 0.946). Apparent diffusion coefficients 2 weeks after the first NACT were significantly increased compared with those before chemotherapy both in the axial and sagittal planes (P = 0.003, P = 0.012). In the ineffective group, ADCs 2 weeks after the first NACT were not statistically higher than those before chemotherapy (axial planes, P = 0.694; sagittal planes, P = 0.900). After 2 weeks of the first NACT, ADCs in both planes were obviously increased in the effective group than those in the ineffective group (P = 0.043, P = 0.022).
The axial and sagittal DWI may detect the changes in LACC after therapy. Apparent diffusion coefficient values measured both in the 2 planes may be used to evaluate the response of LACC to NACT.
本研究旨在探讨局部晚期宫颈癌（LACC）在矢状面和轴位磁共振弥散加权成像（DWI）是否可用于评估 LACC 对新辅助化疗（NACT）的反应。
30 例 LACC 患者分别于 NACT 前、NACT 后 2 周及 NACT 后 2 周接受常规磁共振成像和 DWI 检查。根据 NACT 后 2 周肿瘤大小的变化判断治疗反应，分为有效组和无效组。比较 2 个成像平面的表观扩散系数（ADC），观察不同化疗敏感组和成像平面的 ADC 变化。采用单因素方差分析比较这些 ADC 参数与肿瘤反应之间的关系。
有效化疗率为 76.67%。3 个时间点轴位 DWI 的 ADC 值分别为 0.88（SD，0.08）×10⁻³mm²/s、0.96（SD，0.10）×10⁻³mm²/s 和 1.19（SD，0.11）×10⁻³mm²/s，而矢状位的 ADC 值分别为 0.89（SD，0.09）×10⁻³mm²/s、0.97（SD，0.12）×10⁻³mm²/s 和 1.19（SD，0.12）×10⁻³mm²/s。3 个时间点 2 个平面的 ADC 值差异均无统计学意义（P=0.927、P=0.863、P=0.946）。NACT 后 2 周，与化疗前相比，2 个平面的 ADC 值均显著升高（P=0.003、P=0.012）。在无效组中，NACT 后 2 周 ADC 值与化疗前相比无统计学差异（轴位，P=0.694；矢状位，P=0.900）。在有效组中，NACT 后 2 周，2 个平面的 ADC 值均明显高于无效组（P=0.043、P=0.022）。
轴位和矢状位 DWI 可检测 LACC 治疗后的变化。2 个平面测量的 ADC 值可用于评估 LACC 对 NACT 的反应。
