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Cervical cancer apparent diffusion coefficient values during external beam radiotherapy.

Peter de Boer1,2, Stefano Mandija3, Anita M Werensteijn-Honingh1

  • 1Department of Radiation Oncology, University Medical Centre Utrecht, The Netherlands.

Physics and Imaging in Radiation Oncology
|January 18, 2021
PubMed
Summary
This summary is machine-generated.

Apparent diffusion coefficient (ADC) changes during chemoradiation for cervical cancer show significant increases in tumors and lymph nodes. While lower tumor volume decrease correlated with relapse, the ADC change itself was not a statistically significant predictor.

Keywords:
ADC mapCervical cancerMRI

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Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Apparent diffusion coefficient (ADC) reflects micro-environmental changes.
  • ADC may predict recurrence before brachytherapy for cervical cancer.

Purpose of the Study:

  • Evaluate changes in ADC of primary tumors and lymph nodes during chemoradiation.
  • Correlate ADC changes with clinical outcomes in locally advanced cervical cancer.

Main Methods:

  • Included 20 patients with locally advanced cervical cancer treated with chemoradiation.
  • Acquired MRI with diffusion-weighted imaging (b-values 0, 200, 800 s/mm²) at baseline and weeks 1/2, 3, and 4.
  • Delineated primary tumors on T2 and ADC maps, and lymph nodes on ADC maps.

Main Results:

  • Significant ADC signal increase observed in primary tumors (0.94 to 1.13 × 10⁻³ mm²/s) and lymph nodes (0.79 to 1.14 × 10⁻³ mm²/s) (p < 0.001).
  • Tumor and lymph node volumes decreased by 51% and 40%, respectively.
  • Four patients relapsed; lower median primary tumor volume decrease (19% vs. 57%) was noted in relapsing patients, but ΔADC showed no clear relation.

Conclusions:

  • ADC values can be reliably acquired, even with T2-based tumor delineations.
  • While plausible, the study did not find a statistically significant correlation between ΔADC and treatment response or recurrence.
  • Lower tumor volume decrease may indicate a higher risk of relapse.