Saikat Das1, Anuradha Chandramohan2, Jeba Karunya Rami Reddy3, Sramana Mukhopadhyay4, Ramani Manoj Kumar4, Rajesh Isiah3, Subhashini John3, Regi Oommen5, Visalakshi Jeyaseelan6. 1. Department of Radiation Oncology, Christian Medical College Vellore, India. Electronic address: saikat@cmcvellore.ac.in. 2. Department of Radiology, Christian Medical College Vellore, India. 3. Department of Radiation Oncology, Christian Medical College Vellore, India. 4. Department of General Pathology, Christian Medical College Vellore, India. 5. Department of Nuclear Medicine, Christian Medical College Vellore, India. 6. Department of Biostatistics, Christian Medical College Vellore, India.
Abstract
BACKGROUND AND PURPOSE: To assess the diagnostic performance of conventional and diffusion weighted (DWI) magnetic resonance imaging (MRI) in predicting response in locally advanced cervical cancer. MATERIALS AND METHODS: Total 24 patients with stage IIB-IIIB squamous cell carcinoma cervix were treated with initial two cycles of paclitaxel and carboplatin and concurrent low dose radiotherapy prior to standard chemoradiation. Response was assessed clinically and radiologically after 3 weeks of initial treatment. Volumetric and functional parameters derived from conventional and diffusion weighted MRI, due to treatment were measured. RESULTS: Significant reduction of GTV was noted in MRI (54 cm(3) vs. 11 cm(3), p < 0.01) and DWI (44 cm(3) vs. 6 cm(3), p < 0.01, ΔADC = 0.49 × 10(-3)mm(2)/sec, p < 0.01) after treatment. Tumor volume reduction rate (TVRR) in DWI was significantly higher in pathological good responders (p = 0.03). In this group both mean post treatment apparent diffusion coefficient (ADC) value and ΔADC were significantly higher (p = 0.01 and p = 0.03). ADC was a good predictor for pathological response (area under receiver operating characteristic curve (ROC) 0.814). CONCLUSION: TVRR (DWI) and ΔADC can be used as a predictor of early pathological response. Complete response based on DWI, could be a useful predictor of long term disease control.
BACKGROUND AND PURPOSE: To assess the diagnostic performance of conventional and diffusion weighted (DWI) magnetic resonance imaging (MRI) in predicting response in locally advanced cervical cancer. MATERIALS AND METHODS: Total 24 patients with stage IIB-IIIB squamous cell carcinoma cervix were treated with initial two cycles of paclitaxel and carboplatin and concurrent low dose radiotherapy prior to standard chemoradiation. Response was assessed clinically and radiologically after 3 weeks of initial treatment. Volumetric and functional parameters derived from conventional and diffusion weighted MRI, due to treatment were measured. RESULTS: Significant reduction of GTV was noted in MRI (54 cm(3) vs. 11 cm(3), p < 0.01) and DWI (44 cm(3) vs. 6 cm(3), p < 0.01, ΔADC = 0.49 × 10(-3)mm(2)/sec, p < 0.01) after treatment. Tumor volume reduction rate (TVRR) in DWI was significantly higher in pathological good responders (p = 0.03). In this group both mean post treatment apparent diffusion coefficient (ADC) value and ΔADC were significantly higher (p = 0.01 and p = 0.03). ADC was a good predictor for pathological response (area under receiver operating characteristic curve (ROC) 0.814). CONCLUSION: TVRR (DWI) and ΔADC can be used as a predictor of early pathological response. Complete response based on DWI, could be a useful predictor of long term disease control.
Authors: Benjamin Lewis; Anamaria Guta; Stacie Mackey; H Michael Gach; Sasa Mutic; Olga Green; Taeho Kim Journal: J Appl Clin Med Phys Date: 2021-01-15 Impact factor: 2.102
Authors: John M Floberg; Kathryn J Fowler; Dominique Fuser; Todd A DeWees; Farrokh Dehdashti; Barry A Siegel; Richard L Wahl; Julie K Schwarz; Perry W Grigsby Journal: EJNMMI Res Date: 2018-06-15 Impact factor: 3.138