| Part ?:Early monitoring treatment efficiency of cervical cancer under concurrent chemo-radiotherapy by intravoxel incoherent motion(IVIM)MR imagingObjective:To explore the potential of intravoxel incoherent motion(IVIM)MR imaging in predicting outcome and measuring response to concurrent chemo-radiotherapy(CCRT)in advanced cervical cancers.Methods and Materials:Thirty-seven patients with advanced cervical cancers scheduled for CCRT underwent MR examinations including IVIM sequence with 14 b values(0?1000 s/mm2)before CCRT,2 and 4 weeks after the initiation of CCRT,and immediately after CCRT.Apparent diffusion coefficient(ADC),f,D as well as D*values were obtained during the course.The maximum diameter of the tumor was measured to determine the treatment efficiency.Results:At the end of CCRT,25 patients were classified as complete response(CR)and 12 as partial response(PR).The pre-treatment f of cervical cancer showed its efficiency in predicting PR and CR with an area under receiver operating characteristic curve(AUC)of 0.768.During CCRT,the ADC,D and D*values kept on rising,while f increased first and then decreased after 4 weeks' CCRT.The f value increased 73.38 ± 83.19%as early as 2 weeks after the initiation of CCRT.Conclusions:IVIM-MR imaging held great potential in both predicting and early monitoring treatment efficiency of advanced cervical cancer under CCRTPart ?:Prognostic value of intravoxel incoherent motion(IVIM)MR imaging in patients with advanced cervical cancers treated with concurrent chemo-radiotherapyObjective:By using intravoxel incoherent motion(IVIM)model,diffusion-related coefficient(D)and perfusion-related parameter(f)can be obtained simultaneously.Here,we explored thve application of IVIM MR imaging in predicting long-term prognosis in patients with advanced cervical cancers treated with concurrent chemo-radiotherapy(CCRT).Methods and Materials:Pelvic MR examinations including IVIM sequence were performed in 30 women with advanced cervical cancers at three time points(within 2 weeks before,2 and 4 weeks after the initiation of CCRT).The performance of tumor size and IVIM-derived parameters in predicting long-term prognosis was evaluated.Results:After a median follow-up of 21 months(range,7?31months),25/30(83.33%)patients were alive and 21/30(70.00%)remained free of disease.A shrinkage rate of maximum diameter(time point 1 vs.3)? 58.31%was useful in prediction of a good long-term prognosis.The IVIM-derived apparent diffusion coefficient(ADCIVIM)value at time point 2,the ADCIVIM and f values at time point 3 also performed well in predicting good long-term outcome with an area under ROC curve of 0.767,0.857 and 0.820,respectively.Conclusion:IVIM MR imaging hold great potential in predicting long-term prognosis in patients with advanced cervical cancers treated with CCRT.Part ?:Semi-quantitative dynamic contrast-enhanced MR imaging in predicting prognosis of cervical cancer patients undergone concurrent chemo-radiotherapyObjective:To investigate the role of semi-quantitative dynamic contrast-enhanced(DCE)magnetic resonance(MR)imaging(DCE-MRI)in predicting the long-term prognosis of patients with advanced cervical cancers undergone concurrent chemo-radiotherapy(CCRT).Methods and Materials:Thirty-eight patients(48.8±11.7 years old)with advanced cervical cancers underwent DCE-MRI before CCRT,2 and 4 weeks after CCRT.Semi-quantitative DCE-MRI parameters were measured and compared between patients with well and poor long-term prognosis.Results:Patients with well long-term prognosis had significantly higher wash-in rate of tumor at time point 3(95.26 ± 25.55 L/s)and change rate from time point 1 to 3(42.30±72.48%)compared with those with poor prognosis(46.94±26.62L/s,16.93±22.09%,p<0.000,=0.001).Wash-in rate of tumor at time point 3 could predict a well long-term prognosis with an AUC of 0.910.Conclusion:Semi-quantitative DCE-MRI parameters hold potential in predicting long-term prognosis of patients with advanced cervical cancers treated with CCRT. |
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