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)
-
Jolanta DADONIENĖ,
Dalius JATUŽIS,
Arvydas LAURINAVIČIUS,
The diagnostic value of ultrasound examination in temporal arteritis
,
Acta medica Lituanica: Vol. 17 No. 1-2 (2010)
-
Albertas Ulys,
Alvydas Vėželis,
Marius Snicorius,
Marius Anglickis,
The first clinical experience in prostate cancer salvage cryotherapy
,
Acta medica Lituanica: Vol. 20 No. 4 (2013)
-
Vytautas Vitkauskas,
Narimantas Evaldas Samalavičius,
Marija Vitkauskienė,
Five-year survival after sigmoid resection and low vascular ligation versus left hemicolectomy and high ligation for stage I–III sigmoid carcinoma: a retrospective study
,
Acta medica Lituanica: Vol. 20 No. 4 (2013)
-
Kastytis Žilinskas,
Kristina Maculevič,
Jelena Volochovič,
Jolita Zakarevičienė,
Clinical results of vulvar cancer treatment in early stages based on sentinel lymph node biopsy and classic surgical treatment in the Institute of Oncology of Vilnius University between 2011 and 2013
,
Acta medica Lituanica: Vol. 21 No. 2 (2014)
-
Alvydas Paunksnis,
Ophthalmology in Lithuania
,
Acta medica Lituanica: Vol. 24 No. 2 (2017)
-
Albertas Ulys,
Algirdas Žalimas,
Rūta Merkytė,
Sandra Selickaja,
Mantas Trakymas,
Percutaneous radiofrequency ablation of renal tumours: 29-month mean follow-up results of 118 patients
,
Acta medica Lituanica: Vol. 20 No. 4 (2013)
-
Diana Bilskienė,
Andrius Macas,
Anaesthesia management of a patient in MRT (Magnetic Resonance Tomography). Save working environment – it must be achieved
,
Acta medica Lituanica: Vol. 19 No. 3 (2012)
-
Vytautas Basys,
Nijolė Drazdienė,
Nijolė Vezbergienė,
Jelena Isakova,
Perinatal injury of the central nervous system in Lithuania from 1997 to 2014
,
Acta medica Lituanica: Vol. 23 No. 4 (2016)
-
Saulius Cicėnas,
Vytautas Jonas Sirvydis,
Giedrius Uždavinys,
Gintaras Kalinauskas,
Renatas Aškinis,
Sigitas Zaremba,
Pump operations in locally advanced thoracic malignancies
,
Acta medica Lituanica: Vol. 19 No. 4 (2012)
-
Dainius Šimčikas,
Eligijus Poškus,
Juozas Stanaitis,
Ernesta Rinkevičiūtė,
Algirdas Edvardas Tamošiūnas,
Kęstutis Strupas,
Sporadic duodenal macrogastrinoma: a rare case report
,
Acta medica Lituanica: Vol. 19 No. 4 (2012)