Evaluating early response of cervical cancer under concurrent chemo-radiotherapy by intravoxel incoherent motion MR imaging

• Type of Material: Article
• Authors: Li Zhu, Nanjing University; Lijing Zhu, Nanjing University; Hua Shi, Nanjing University; Huanhuan Wang, Nanjing University; Jing Yan, Nanjing University; Baorui Liu, Nanjing University; Weibo Chen, Philips Healthcare; Jian He, Nanjing University; Zhengyang Zhou, Nanjing University; Xiaofeng Yang, Emory University; Tian Liu, Emory University
• Language: English
• Date: 2016-02-10
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © Zhu et al. 2016. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12885-016-2116-5
• Title of Journal or Parent Work: BMC Cancer
• ISSN: 1471-2407
• Volume: 16
• Issue: 1
• Start Page: 79
• End Page: 79
• Grant/Funding Information: This work was supported by grants from National Natural Science Foundation of China (81371516, 81501441), Natural Science Foundation of Jiangsu Province (BK20150109), Six talent peaks project of Jiangsu Province (2015-WSN-079) and Jiangsu Provincial Health and Family Planning Commission Youth Scientific Research Project (Q201508). Go to:
• Keywords: RADIATION-THERAPY; RADIOTHERAPY; Magnetic resonance imaging; WEIGHTED MRI; TUMOR RESPONSE; Tumor response; Life Sciences & Biomedicine; Oncology; PERFUSION; Cervical cancer; CHEMORADIATION; BREAST-CANCER; Intravoxel incoherent motion MR imaging; PARAMETERS; Concurrent chemo-radiotherapy; Science & Technology; APPARENT DIFFUSION-COEFFICIENT; RECTAL-CARCINOMA
• Research Categories: Health Sciences, Radiology; Health Sciences, Oncology

Abstract

BACKGROUND: Intravoxel incoherent motion (IVIM) MR imaging has been applied in researches of various diseases, however its potential in cervical cancer patients has not been fully explored. The purpose of this study was to investigate the feasibility of IVIM MR imaging to monitor early treatment response in patients receiving concurrent chemo-radiotherapy (CCRT) for advanced cervical cancers. METHODS: Twenty-one patients receiving CCRT for advanced cervical cancer were prospectively enrolled. MR examinations including IVIM imaging (with 14 b values, 0 ~ 1000 s/mm(2)) were performed at 4 time points: 1-week prior to, 2-week and 4-week during, as well as immediately post CCRT (within 1 week). The apparent diffusion coefficient (ADC) maps were derived from the mono-exponential model, while the diffusion coefficient (D), perfusion fraction (f) and pseudo-diffusion coefficient (D*) maps were calculated from the bi-exponential model. Dynamic changes of ADC, D, f and D* in cervical cancers were investigated as early surrogate markers for treatment response. RESULTS: ADC and D values increased throughout the CCRT course. Both f and D* increased in the first 2 to 3 weeks of CCRT and started to decrease around 4 weeks of CCRT. Significant increase of f value was observed from prior to CCRT (f 1 = 0.12 ± 0.52) to two-week during CCRT (f 2 = 0.20 ± 0.90, p = 0.002). CONCLUSIONS: IVIM MR imaging has the potential in monitoring early tumor response induced by CCRT in patients with cervical cancers.