Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd, Haidian District, Beijing, 100142, China.
BMC Cancer. 2019 Nov 15;19(1):1115. doi: 10.1186/s12885-019-6344-3.
The aim was to investigate the prognostic value of MR apparent diffusion coefficients (ADC) using histogram analysis (HA) in predicting disease-free survival (DFS) of cervical cancer after chemo-radiation therapy.
We retrospectively analyzed 103 women with pathologically proven squamous cell uterine cancer who received chemo-radiation therapy between 2009 and 2013. All patients were followed up for more than 2 years. Pre-treatment MR images were retrieved and imported for HA using an in-house developed software program based on 3D Slicer. Regions of interest of whole tumors were drawn manually on DWI with reference to T2WI. HA features (mean, max, min, 50, 10, 90%, kurtosis, and skewness) were extracted from apparent diffusion coefficient (ADC) maps and compared between the recurrence and non-recurrence groups after the 2-year follow-up. Univariate and multivariate Cox regression analysis was used to correlate ADC HA features and relevant clinical variables (age, grade, maximal diameter of tumor, FIGO stage, SCC-Ag) with DFS.
One hundred three patients with stage IB-IV cervical cancers were followed up for 2.0-94.6 months (median 48.9 months). Twenty patients developed recurrence within 2 years. In the recurrence group, the min (P = 0.001) and 10% (P = 0.048) ADC values were significantly lower than those of the non-recurrence group. Univariate and multivariate Cox regression analysis revealed that ADC (P = 0.006, HR = 0.110) was significantly correlated with DFS.
Pre-treatment volumetric ADC in histogram analysis is an independent factor that is correlated with DFS in cervical cancer patients treated with chemo-radiation therapy.
本研究旨在探讨磁共振表观扩散系数（ADC）直方图分析（HA）在预测宫颈癌放化疗后无病生存（DFS）中的预后价值。
回顾性分析了 2009 年至 2013 年间接受放化疗的 103 例经病理证实的宫颈鳞癌患者。所有患者随访时间均超过 2 年。回顾性采集患者治疗前的磁共振图像，并使用基于 3D Slicer 的自主研发软件进行 HA。在 DWI 上参照 T2WI 手动勾画肿瘤全容积 ROI。从 ADC 图中提取 ADC HA 特征（均值、最大值、最小值、50%、10%、90%、峰度和偏度），并在 2 年随访后比较复发组和非复发组之间的差异。采用单因素和多因素 Cox 回归分析，将 ADC HA 特征与年龄、分级、肿瘤最大直径、FIGO 分期、SCC-Ag 等相关临床变量与 DFS 进行相关性分析。
103 例 IB-IV 期宫颈癌患者随访时间为 2.0-94.6 个月（中位随访时间为 48.9 个月）。2 年内 20 例患者复发。复发组 ADC 的最小值（P=0.001）和 10%（P=0.048）明显低于非复发组。单因素和多因素 Cox 回归分析显示，ADC（P=0.006，HR=0.110）与 DFS 显著相关。
放化疗前 ADC 直方图分析的体积参数是与宫颈癌患者放化疗后 DFS 相关的独立因素。
