Gu, Kyo-Won; Kim, Chan Kyo; Choi, Chel Hun; Yoon, Young Cheol; Park, Won
European radiology
2019Apr ; 127 ( 4 ) :.
PMID : 30980126
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Gu, Kyo-Won -
Kim, Chan Kyo -
Choi, Chel Hun -
Yoon, Young Cheol -
Park, Won -
ABSTRACT
OBJECTIVES: To investigate the prognostic value of diffusion-weighted imaging (DWI) in predicting clinical outcome in patients with cervical cancer after concurrent chemoradiotherapy (CCRT).
METHODS: We enrolled 124 cervical cancer patients who received definitive CCRT and underwent 3?T-MRI before and 1?month after initiating treatment. The mean apparent diffusion coefficient (ADC) value was measured on the tumor and the changes in ADC percentage (?ADC(mean)) between the two time points were calculated. The Cox proportion hazard model was used to evaluate the associations between imaging or clinical variables and progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS).
RESULTS: In multivariate analysis, ?ADC(mean) was the only independent predictor of PFS (hazard ratio [HR]?=?0.2379, p?=?0.005), CSS (HR?=?0.310, p?=?0.024), and OS (HR?=?0.217, p?=?0.002). Squamous cell carcinoma antigen, histology, and pretreatment tumor size were significantly independent predictors of PFS. Tumor size response was significantly independent predictor of CSS and OS. Using the cutoff values of ?ADC(mean), the PFS was significantly lower for ?ADC(mean)
keyword
Cervical cancer; Concurrent chemoradiotherapy; Diffusion-weighted imaging; Magnetic resonance imaging; Treatment outcome
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