Feng Yusen, Liu Hui, Ding Yingying, Zhang Ya, Liao Chengde, Jin Yan, Ai Conghui
Department of Radiology, Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming Yan'an Hospital, Kunming, China.
Department of Radiology, Third Affiliated Hospital of Kunming Medical University, Kunming, China.
Tumori. 2020 Apr;106(2):155-164. doi: 10.1177/0300891619886656. Epub 2019 Nov 18.
To prospectively investigate changes in quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in patients with cervical cancer before and after neoadjuvant chemotherapy (NACT).
Thirty-eight patients with cervical cancer underwent DCE-MRI and DWI 1 week before and 4 weeks after NACT. The patients were classified into 2 groups: significant reaction (sCR) group and the non-sCR group. DCE-MRI parameters and ADC values were measured and compared between the 2 groups.
Before NACT, the mean K value was higher, but the mean V was lower, in the sCR group compared with the non-sCR group; these differences were statistically significant (<0.05). After NACT, the mean K value and the delta (i.e., changed) value of K were significantly lower in the sCR group compared with the non-sCR group (<0.05). However, the mean ADC and the delta value of the mean ADC between the 2 groups were slightly higher in the sCR group compared with the non-sCR group (<0.05). The area under the curve of pre-mean K, DK, and pre-mean K combined with post-mean ADC values were 0.801, 0.955, and 0.878, respectively (<0.05). The optimal cutoff values for distinguishing sCR from non-sCR were pretreatment K (0.7020 min) and DK (0.0437 min).
Quantitative parameters (pre-mean K, DK, and pre-mean K) combined with post-mean ADC could predict treatment efficacy more precisely. However, quantitative DCE-MRI combined with DWI could not significantly improve prognostic efficacy.
前瞻性研究新辅助化疗（NACT）前后宫颈癌患者动态对比增强磁共振成像（DCE-MRI）定量参数及扩散加权成像（DWI）的表观扩散系数（ADC）的变化。
38例宫颈癌患者在NACT前1周及NACT后4周接受DCE-MRI和DWI检查。患者分为2组：显著反应（sCR）组和非sCR组。测量并比较两组的DCE-MRI参数和ADC值。
NACT前，sCR组的平均K值较高，但平均V值较低，与非sCR组相比，这些差异具有统计学意义（<0.05）。NACT后，sCR组的平均K值和K的变化值（即ΔK）显著低于非sCR组（<0.05）。然而，sCR组的平均ADC及两组间平均ADC的变化值略高于非sCR组（<0.05）。平均K值、ΔK值及平均K值与平均ADC值联合的曲线下面积分别为0.801、0.955和0.878（<0.05）。区分sCR与非sCR的最佳临界值为治疗前K值（0.7020 min）和ΔK值（0.0437 min）。
定量参数（平均K值、ΔK值和平均K值）与平均ADC值联合可更准确地预测治疗疗效。然而，定量DCE-MRI联合DWI并不能显著提高预后评估效能。
