Purpose
DW-MRI has the potential to provide a standardized imaging measurement in therapeutic responseevaluation.
We investigate the possibility of DWI as an imaging bio marker and evaluate its ability to measure tumorresponse in carcinoma cervix.
Aims:
To measure the apparent diffusion coefficient (ADC) values in cervical cancers
To measure serial apparent diffusion coefficient (ADC) values for cervical cancer before,
during and after chemo radiotherapy.
To correlate the ADC values with loco regional outcome.
To investigate the role of diffusion-weighted imaging (DWI) in predicting and monitoring chemo...
Methods and materials
Study was approved by an independent ethical committee.
30 patients with carcinoma cervix,
who underwent chemo radiation therapy were examined with pelvic MRI and DWI before initiation of chemoradiation,
after completing external beam radiotherapy and following completion of brachytherapy with a 1.5-T MRscanner and a 16 channel torso coil.
MR Imaging protocol consisted of pulse sequences,
with and without contrast,
with parameters as shown in Table 1&2.
Table 1
Parameters
T1
T2
T2 CERVIX (axis of cervix)
AXIAL
AXIAL
CORONAL
SAGITTAL
AXIAL SPAIR
AXIAL
CORONAL...
Results
Most of the patients were among 41-60 years (63.3 %),
with mean age of 51.63±9.63 years .
Distribution of patients according treatment type
Treatment
No.
of patients(n=30)
%
CCRT
22
73.3
Neoadjuvant chemotherapy+CCR
8
26.7
Total
30
100.0
Distribution of patients according to treatment response
Response group
No.
of patients(n=30)
%
Complete Response
2
6.7
Good Response
17
56.7
Partial Response
11
36.7
Total
30
100.0
Pre,
mid and post treatment comparative response evaluation of tumour size,
volume and ADC.Table 1.
A significant difference was...
Conclusion
The addition of diffusion weighted imaging to the conventional magnetic resonance imaging protocol allows precise assessment of uterine cervical carcinoma,
from lesion detection and characterization to staging of tumor.
When used in conjunction with apparent diffusion coefficient mapping ,
diffusion weighted imaging is a powerful tool with the potential for early and accurate prediction ,
assessment and monitoring of response to chemo radiation therapy.
Based on our data we found that:
Most of the patients with uterine cervical carcinoma are in the age group...
Personal information
Dr Prachi Kala,
MD.
Sectional Imaging division,
Department of Radiology,
Vydehi institute of medical sciences,
Bangalore,
India.
[email protected]
Dr Vidya Bhargavi,
Resident,Department of radiology,
Vydehi institute of medical sciences,
Bangalore,
India.
Dr Rohini Avantsa,
MD.
Department of radiology,
Vydehi institute of medical sciences,
Bangalore,
India.
[email protected]
References
1. Chen Jianyu,
ZhangYun,
LiangBiling ,
YangZehong. The utility of diffusion-weighted MR imaging in cervical cancer .
European Journal of Radiology 74 (2010) 101–106.
2. Evis Sala,
Andrea Rockall,
Deepa Rangarajan,
Rahel A.
The role of dynamic contrast enhanced and diffusion weighted magnetic resonance imaging in the female pelvis.
European Journal of Radiology 76 (2010) 367 –385.
3. Hyun Su Kim,
Chan Kyo Kim,
Byung Kwan.
Evaluation of therapeutic response to concurrent chemoradiotherapy in patients with cervical cancer using diffusion weighted MR imaging. Journal Of...