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• Clinical Article •
The clinical value of IVIM-MRI and DWI in evaluating and predicting the efficacy of concurrent chemoradiotherapy for locally advanced cervical cancer
CHEN Xiaoli  XU Yongsheng  YIN Liang  LEI Junqiang 

Cite this article as: Chen XL, Xu YS, Yin L, et al. The clinical value of IVIM-MRI and DWI in evaluating and predicting the efficacy of concurrent chemoradiotherapy for locally advanced cervical cancer. Chin J Magn Reson Imaging, 2020, 11(9): 776-780. DOI:10.12015/issn.1674-8034.2020.09.011.


[Abstract] Objective: To explore the value of parameters related to intravoxel incoherent motion (IVIM) and diffusion weighted imaging (DWI) in evaluating and predicting the treatment efficacy of locally advanced cervical cancer under concurrent chemoradiotherapy (CCRT).Materials and Methods: Twenty-one patients with locally advanced cervical cancer underwent pelvic 3.0 T MRI scan including T1WI, T2WI, DWI and IVIM (10 b values, 0—1000 s/mm2) within 1 week before CCRT, 2 and 4 weeks after the initiation of CCRT, and 1 month after CCRT. The parameters at different time points were measured before and after CCRT. Including ADC, D, f, D* as well as the maximum tumor diameter at each scan time point, and calculate the change rate of each parameter after treatment and the tumor regression rate. Patients were divided into 13 cases in the complete remission (CR) and 8 cases in the partial remission (PR) groups according to RECIST 1.1 criteria, there were no stable group (SD) and progression group (PD). The parameters and their percentages were compared between the two groups before and after CCRT at at each time point by independent-samples-t test, ROC curves were applied to analyze the effect of the response evaluation of parameters and their change percentages (Δ%), Pearson correlation test were applied to analyze the relationship between the parameters as well as their change percentages (Δ%) and tumor regression rate (TSO).Results: The maximum diameter of the tumor before treatment and 1 month after the treatment was (4.64±1.31) cm and (0.40±0.53) cm. The tumor regression rate was 0.91 %±0.11 %. There were 13 patients in CR group and 8 patients in PR group. The ADC of CR group was lower than that of PR group before treatment while f value was higher than that of PR group (P<0.05), the Δ%ADC and Δ%D of CR group were higher than that of PR group (P<0.05). The Δ%f of CR group was lower than that of PR group after 1 month of treatment (P<0.05). The TSO revealed a negative correlation with pre ADC (r=-0.462, P<0.05), and a positive correlation with pre f, Δ%ADC and Δ%D 2 and 4 weeks after trearment (r=0.614, 0.487, 0.64, 0.451, 0.428, all P<0.05). In the prediction of CR group and PR group, the AUC of pre f, pre ADC, Δ%D, Δ%ADC at 2 weeks and 4 weeks after treatment were (0.904, 0.788, 0.868, 0.846, 0.803, 0.798 respectively).Conclusions: The quantitative parameters of IVIM and DWI and their change percentages are helpful in predicting and monitoring the treatment efficacy of chemoradiotherapy for cervical cancer before and after treatment and IVIM has higher evaluation efficiency.
[Keywords] uterine cervical neoplasms；neoplasms, squamous cell；chemoradiotherapy；magnetic resonance imaging

CHEN Xiaoli Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China

XU Yongsheng Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China

YIN Liang Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China

LEI Junqiang* Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China

*Correspondence to: Lei JQ, E-mail: leijq1990@163.com

Conflicts of interest   None.

Received  2020-03-20
Accepted  2020-07-28
DOI: 10.12015/issn.1674-8034.2020.09.011
Cite this article as: Chen XL, Xu YS, Yin L, et al. The clinical value of IVIM-MRI and DWI in evaluating and predicting the efficacy of concurrent chemoradiotherapy for locally advanced cervical cancer. Chin J Magn Reson Imaging, 2020, 11(9): 776-780. DOI:10.12015/issn.1674-8034.2020.09.011.

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