Abstract
Background. Diffusion-weighted magnetic resonance imaging (DW–MRI) has been employed in the diagnostics of malignant tumors of abdomen and pelvis relatively recently. Nowadays, there exists a particular interest in adaptation DW–MRI for assessing the response of tumors to chemoradiaton therapy. The aim of our study was to compare the mean value of the apparent diffusion coefficient (ADC) in a healthy cervix, cancer-affected cervix and a cervix after chemoradiation therapy, as well as to identify the ADC range typical of cervical cancer.
Materials and methods. The study enrolled 108 female patients who underwent pelvic MRI in the Lithuanian University of Health Sciences Kaunas Clinics Hospital in 2008–2010. The study group consisted of 65 patients in whom cervical cancer had been clinically suspected and confirmed by biopsy before MRI examination. All these patients underwent pelvic MRI twice: before the chemoradiation therapy and 6 months after the therapy. The control group consisted of 43 patients in whom cervical cancer had been not suspected and MRI was performed because of other pelvic diseases.
Results. The mean ADC value of the study group (0.658 ± 0.118 × 10–3 mm2/s) was lower than of the control group (1.171 ± 0.143 × 10–3 mm2/s) (t = 20.315, p = 0.03). The ADC threshold value of 0.945 × 10–3 mm2/s was defined, differentiating the cancer-affected cervical tissue from the normal. The mean ADC value of the patients who responded to chemoradiation therapy (1.111 ± 0.138 × 10–3 mm2/s) increased and in those who did not respond it remained lower (0.733 ± 0.073 × 10–3 mm2/s) (t = 9.518, p = 0.04). The ADC threshold value of 0.830 × 10–3 mm2/s was defined, differentiating the residual tumor tissue from the healthy cervical tissue after chemoradiation therapy.
Conclusions. The ADC value in the case of cervical cancer was significantly lower than in the non-affected cervical tissue. The ADC value increases after effective chemoradiation therapy and becomes closer to the coefficient value of non-affected cervical tissue, but still remains lower. The 0.945 × 10–3 mm2/s ADC threshold was detected while differentiating between cancer-affected and normal cervical tissues, while the ADC threshold was 0.830 × 10–3 mm2/s when differentiating between residual tumor tissue and healthy cervical tissue after chemoradiation therapy at a high sensitivity and specificity.
Keywords: diffusion-weighted magnetic resonance imaging, apparent diffusion coefficient, cervical cancer, chemoradiation therapy
Downloads
Download data is not yet available.
Most read articles by the same author(s)
-
Laura Steponavičienė,
Rasa Vansevičiūtė,
Lina Zabulienė,
Domantas Jasilionis,
Vincas Urbonas,
Giedrė Smailytė,
Reproductive Factors and Breast Cancer Risk in Lithuanian Women: A Population-Based Cohort Study
,
Acta medica Lituanica: Vol. 27 No. 2 (2020): Acta medica Lituanica
-
Luize Auzina,
Inguna Lubaua,
Elina Ligere,
Inga Lace,
Inta Bergmane,
Baiba Matsone-Matsate,
Pauls Silis,
Lauris Smits,
Normunds Sikora,
Lars Søndergaard,
Valts Ozolins,
Initial experience with Edwards SAPIEN valve transcatheter implantation in native RVOT in Latvia
,
Acta medica Lituanica: Vol. 27 No. 1 (2020): Acta medica Lituanica
-
Raimondas Juškys,
Eligijus Poškus,
Augustas Beiša,
Liutauras Gumbys,
Donatas Jocius,
Raimundas Meškauskas,
Kęstutis Strupas,
High-grade well-differentiated neuroendocrine tumour of the cecum diagnosed following incisional hernia repair: a case report
,
Acta medica Lituanica: Vol. 27 No. 1 (2020): Acta medica Lituanica
-
Jadvyga SUBAČIŪTĖ,
Spinal meningioma surgery: predictive factors of outcome
,
Acta medica Lituanica: Vol. 17 No. 3-4 (2010)
-
Vilius Rudaitis,
Ugnius Mickys,
Justina Katinaitė,
Justyna Dulko,
Successful treatment of advanced stage yolk sac tumour of extragonadal origin: a case report and review of literature
,
Acta medica Lituanica: Vol. 23 No. 2 (2016)
-
Airida Narkutė,
Virginija Žilinskaitė,
Overview of caustic ingestion cases at the Children’s Hospital of Vilnius University Hospital Santaros klinikos between 2011 and 2018
,
Acta medica Lituanica: Vol. 26 No. 4 (2019): Acta Medica Lituanica
-
Jolanta Šumskienė,
Edita Šveikauskaitė,
Jūratė Kondrackienė,
Limas Kupčinskas,
Aorto-duodenal fistula: a rare but serious complication of gastrointestinal hemorrhage. A case report
,
Acta medica Lituanica: Vol. 23 No. 3 (2016)
-
Dionysios Prevezanos,
Nikolaos Garmpis,
Dimitrios Dimitroulis,
Anna Garmpi,
Vasiliki Epameinondas Georgakopoulou,
Christos Damaskos,
Polycystic Horseshoe Kidney: A Rare Coexistence as a Challenge for the Surgeons. Case Report
,
Acta medica Lituanica: Vol. 29 No. 2 (2022): Acta medica Lituanica
-
Jelena ISAJEVA,
Mindaugas ŠILKŪNAS,
Gražina Stanislava DRĄSUTIENĖ,
Daiva BARTKEVIČIENĖ,
Features of the sexual life during pregnancy
,
Acta medica Lituanica: Vol. 19 No. 2 (2012)
-
Greta Bakavičiūtė,
Sabina Špiliauskaitė,
Audronė Meškauskienė,
Diana Ramašauskaitė,
Laparoscopic repair of the uterine scar defect – successful treatment of secondary infertility: a case report and literature review
,
Acta medica Lituanica: Vol. 23 No. 4 (2016)