Kuang Fei, Yan Ziping, Wang Jian, Rao Ziyuan
Department of Medical Imaging, The 174th Hospital of Chinese PLA, No 96, Wen Yuan Road, Xiamen, Fujian Province 361003, China.
Department of Medical Imaging, The 174th Hospital of Chinese PLA, No 96, Wen Yuan Road, Xiamen, Fujian Province 361003, China.
Magn Reson Imaging. 2014 May;32(4):342-9. doi: 10.1016/j.mri.2013.12.007. Epub 2013 Dec 27.
To investigate the value of apparent diffusion coefficient (ADC) to predict and monitor the therapy response for cervical cancer patients receiving concurrent radiochemotherapy, and to analyze the influence of different b-value combinations on ADC-based evaluation of treatment response.
Seventy-five cervical cancer patients treated with radiochemotherapy received conventional MRI and DWI prior to therapy, after 2 weeks of therapy, after four weeks of therapy and after therapy completion. Treatment response was classified as complete response (CR, n=35), partial response (PR, n=22) and stable disease (SD, n=18), which was determined according to final tumor size after 6 months of therapy completion. Dynamic changes of apparent diffusion coefficients (ADC) and tumor size in the three tumor groups were observed and compared. All the ADCs were calculated from b=0, 600s/mm(2) and b=0, 1000s/mm(2).
The ADC increased percentage was higher in CR group than those in PR and SD groups after two weeks and four weeks of therapy, with significant differences in absolute ADCs between CR and PR, SD groups after therapy completion; the overall discriminatory capability for differentiation of CR and PR, SD groups was higher for high b-value combination (0, 1000s/mm(2)) than for low b-value combination (0, 600s/mm(2)).
DWI can be used as a predictive and monitoring biomarker of treatment response to radiochemotherapy in patients with cervical cancer. High b-value combination may be more reliable to evaluate the treatment response for cervical cancer.
探讨表观扩散系数（ADC）预测和监测接受同步放化疗的宫颈癌患者治疗反应的价值，并分析不同b值组合对基于ADC评估治疗反应的影响。
75例接受放化疗的宫颈癌患者在治疗前、治疗2周后、治疗4周后及治疗结束后接受常规MRI和DWI检查。治疗反应分为完全缓解（CR，n = 35）、部分缓解（PR，n = 22）和疾病稳定（SD，n = 18），根据治疗结束6个月后的最终肿瘤大小确定。观察并比较三组肿瘤中表观扩散系数（ADC）和肿瘤大小的动态变化。所有ADC均根据b = 0、600s/mm²和b = 0、1000s/mm²计算得出。
治疗2周和4周后，CR组的ADC增加百分比高于PR组和SD组，治疗结束后CR组与PR组、SD组之间的绝对ADC存在显著差异；高b值组合（0，1000s/mm²）对CR组与PR组、SD组的总体鉴别能力高于低b值组合（0，600s/mm²）。
DWI可作为宫颈癌患者放化疗治疗反应的预测和监测生物标志物。高b值组合可能更可靠地评估宫颈癌的治疗反应。
