OBJECTIVES: To assess the predictive value of diffusion weighted imaging (DWI) for survival in women treated for advanced cancer of the cervix with concurrent chemo-radiotherapy. METHODS: Twenty women treated for advanced cancer of the cervix were recruited and followed up for a median of 26 (range <1 to 43) months. They each had DWI performed before treatment, 2 weeks after beginning therapy (midtreatment) and at the end of treatment. Apparent diffusion coefficient (ADC) values were calculated from regions of interest (ROI). All participants were reviewed for follow-up data. ADC values were compared with mortality status (Mann-Whitney test). Time to progression and overall survival were assessed (Kaplan-Meier survival graphs). RESULTS: There were 14 survivors. The median midtreatment ADC was statistically significantly higher in those alive compared to the non-survivors, 1.55 and 1.36 (×10(-3)/mm(2)/s), respectively, P = 0.02. The median change in ADC 14 days after treatment commencement was significantly higher in the alive group compared to non-survivors, 0.28 and 0.14 (×10(-3)/mm(2)/s), respectively, P = 0.02. There was no evidence of a difference between survivors and non-survivors for pretreatment baseline or post-therapy ADC values. CONCLUSION: Functional DWI early in the treatment of advanced cancer of the cervix may provide useful information in predicting survival. KEY POINTS : • Diffusion weighted magnetic resonance imaging (DWI) is increasingly used in cervical cancer. • Functional DWI early in treatment of cervical cancer may help predict survival. • DWI may help clinicians to tailor or individualise treatment appropriately. • This may limit toxicity from ineffective treatment and allow early alternative therapy.
OBJECTIVES: To assess the predictive value of diffusion weighted imaging (DWI) for survival in women treated for advanced cancer of the cervix with concurrent chemo-radiotherapy. METHODS: Twenty women treated for advanced cancer of the cervix were recruited and followed up for a median of 26 (range <1 to 43) months. They each had DWI performed before treatment, 2 weeks after beginning therapy (midtreatment) and at the end of treatment. Apparent diffusion coefficient (ADC) values were calculated from regions of interest (ROI). All participants were reviewed for follow-up data. ADC values were compared with mortality status (Mann-Whitney test). Time to progression and overall survival were assessed (Kaplan-Meier survival graphs). RESULTS: There were 14 survivors. The median midtreatment ADC was statistically significantly higher in those alive compared to the non-survivors, 1.55 and 1.36 (×10(-3)/mm(2)/s), respectively, P = 0.02. The median change in ADC 14 days after treatment commencement was significantly higher in the alive group compared to non-survivors, 0.28 and 0.14 (×10(-3)/mm(2)/s), respectively, P = 0.02. There was no evidence of a difference between survivors and non-survivors for pretreatment baseline or post-therapy ADC values. CONCLUSION: Functional DWI early in the treatment of advanced cancer of the cervix may provide useful information in predicting survival. KEY POINTS : • Diffusion weighted magnetic resonance imaging (DWI) is increasingly used in cervical cancer. • Functional DWI early in treatment of cervical cancer may help predict survival. • DWI may help clinicians to tailor or individualise treatment appropriately. • This may limit toxicity from ineffective treatment and allow early alternative therapy.
Authors: Kuei C Lee; Bradford A Moffat; Anne F Schott; Rachel Layman; Steven Ellingworth; Rebecca Juliar; Amjad P Khan; Mark Helvie; Charles R Meyer; Thomas L Chenevert; Alnawaz Rehemtulla; Brian D Ross Journal: Clin Cancer Res Date: 2007-01-15 Impact factor: 12.531
Authors: Dow-Mu Koh; Erica Scurr; David Collins; Baris Kanber; Andrew Norman; Martin O Leach; Janet E Husband Journal: AJR Am J Roentgenol Date: 2007-04 Impact factor: 3.959
Authors: Daniel A Hamstra; Thomas L Chenevert; Bradford A Moffat; Timothy D Johnson; Charles R Meyer; Suresh K Mukherji; Douglas J Quint; Stephen S Gebarski; Xiaoying Fan; Christina I Tsien; Theodore S Lawrence; Larry Junck; Alnawaz Rehemtulla; Brian D Ross Journal: Proc Natl Acad Sci U S A Date: 2005-11-02 Impact factor: 11.205
Authors: Martine Franckena; Ludy C Lutgens; Peter C Koper; Catharina E Kleynen; Elsbieta M van der Steen-Banasik; Jan J Jobsen; Jan Willem Leer; Carien L Creutzberg; Michel F Dielwart; Yvette van Norden; Richard A M Canters; Gerard C van Rhoon; Jacoba van der Zee Journal: Int J Radiat Oncol Biol Phys Date: 2008-11-05 Impact factor: 7.038
Authors: Eleni Liapi; Jean-Francois Geschwind; Josephina A Vossen; Manon Buijs; Christos S Georgiades; David A Bluemke; Ihab R Kamel Journal: AJR Am J Roentgenol Date: 2008-01 Impact factor: 3.959