Predictive value of diffusion-weighted magnetic resonance imaging during chemoradiotherapy for uterine cervical cancer

AimThe purpose of this study was to evaluate the efficacy of diffusion-weighted (DW) magnetic resonance (MR) imaging to predict the tumor response to chemoradiotherapy (CRT) of uterine cervical cancer. MethodsTwenty-five consecutive patients with pathologically confirmed uterine cervical cancer underwent 1.5-T MR imaging including DW imaging before and during CRT. MR images were reviewed for the size and apparent diffusion coefficient (ADC). Pathological evaluation of the therapeutic effect was performed 3 months after finishing CRT, and we divided the subjects into two groups: complete remission (CR) (n=16) and residual tumor (n=9). ResultsADC was lower before CRT than during CRT (0.890.12 and 1.25 +/- 0.22x10(-3)mm(2)/s, respectively) (P<0.01). ADC change between before and during CRT (ADC) showed a moderate positive correlation (r=0.435, P<0.05) with the tumor regression rates. ADC was higher in the CR group than in the residual tumor group (0.43 +/- 0.23 and 0.25 +/- 0.15x10(-3)mm(2)/s, respectively) (P<0.05). The CR rates were higher in the high ADC group (ADC0.50) than in the low ADC group (ADC<0.49) (100% and 53%, respectively) but marginally significant (P=0.057). The local control rates were not statistically different between high and low ADC groups (83.3% and 73.7%, respectively) (P=0.602). ConclusionDW imaging including ADC measurement may be useful for prediction and early assessment of pathological response to CRT for uterine cervical cancer, but its impact on local disease-free survival was limited.