Accuracy of Diffusion-Weighted Echo-Planar MR Imaging and ADC Mapping in the evaluation of residual Cervical Carcinoma after radiation therapy

Antonin Levy, Caroline Caramella, Cyrus Chargari, Aicha Medjhoul, Annie Rey, Elise Zareski, Bérénice Boulet, François Bidault, Clarisse Dromain, Corinne Balleyguier

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    Résumé

    Objectives: The impact of diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADCs) of MR imaging on the evaluation of residual Uterine Cervical Carcinoma after Radiation Therapy, in addition to conventional MR images. Methods: Fourty-nine women presenting with a uterine cervical cancer were examined with 1.5 T MRI and DWI, 8 (4-20) weeks after treatment. Treatment response was determined based on the histopathological results after therapy and was classified as a complete response (CR) or residual disease (RD). Post-treatment DWI and ADC results were compared. Results: Five (11%) and 44 (89%) patients were considered as having histologically-proven RD or a CR respectively. The mean ADC of cervical tissue for all patients was 1.74 ± 0.324 × 10- 3 mm2/s and the SD was 1.94 ± 1.11 × 10- 4. The mean ADC was 1.62 ± 0.21 × 10- 3 mm2/s (SD = 1.45 × 10- 4) for the 5 patients with RD versus 1.76 ± 0.33 × 10- 3 mm 2/s (SD = 1.99 × 10- 4) for the 44 patients with a CR (p = 0.09). Using 1.7 × 10- 3 mm2/s as a radiological cut-off value for the ADC, all patients classified as having histologically-proven RD had a mean ADC of ≤ 1.7 × 10- 3. In 12 (25%) cases, RD was suspected on T2-weighted MRI images alone. Eight of these cases were considered as false positives compared to the histological results. Their mean ADC was 1.98 × 10- 3 mm2/s and none of them had an ADC of < 1.7 × 10- 3 mm2/s. Conclusion: Although our results were not statistically significant, ADC values could potentially be used to predict and monitor the response of uterine cervical cancer.

    langue originaleAnglais
    Pages (de - à)110-115
    Nombre de pages6
    journalGynecologic Oncology
    Volume123
    Numéro de publication1
    Les DOIs
    étatPublié - 1 oct. 2011

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