| Objective To observe the change of ADC value of lung cancer before and after chemotherapy. To investigate the application value of diffusion-weighted imaging in monitoring and predicting the response of lung cancer to chemotherapy.Materials and Methods Twenty patients diagnosed as lung cancer were included in this study from May 2009 to December 2010 who accepted chemotherapy, the age from 45 to 74 years, the mean age (59.6±7.7years),13 men,7 women. Eight squamous cell carcinoma, Seven adenocarcinomas, Four small cell lung carcinoma,2 non small cell lung carcinoma being not further defined the histological types. The range of the tumor's longest diameter was 2.22～10.83cm, the mean diameter (5.25±2.51cm). All the patients were not suited for surgery underwent clinical evaluation. The 17 patients with non small cell lung carcinoma were stageⅢA,ⅢB disease (7 stageⅢA,10 stageⅢB). All the patients achieved pathologic confirmation and separately accepted gemcitabine,vinorelbine or etoposide and platinum-based chemotherapy regimens.All of them received conventional MRI and DWI examinations before one week and after one month at the initiation of chemotherapy. DWI images and ADC map were got before and after chemotherapy with b-factors of 0,500s/mm2, and the ADC value was measured. The response of lung cancers to chemotherapy were classified into four groups:complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) based on the change of lesion diameter measured on axial T2-weighted MR imaging. The difference of ADC value, the long diameter, short diameter and the mean were compared before and after chemotherapy with Paired-Sample T test; The difference of ADC value was compared between PR and SD before and after chemotherapy respectively with Independent Sample T test. The correlations between the percentage changes of ADCs and the percentage changes of diameters (long, short, and mean) were further evaluated with Pearson correlation coefficient, as well as that between pre-chemotherapy ADCs and the percentage changes of diameters. The results were presented as mean±standard deviation (χ±s) that the test indicated significance for all tests at level of P<0.05. Results1. The mean pre-chemotherapy ADCs was significantly higher than that of the post-chemotherapy ADCs [(1.46±0.448)×10-3mm2/s vs (1.678±0.472)×10-3mm2/s, P=0.002]. The difference of diameters was not statistical significant before and after chemotherapy. Positive correlation was significant between the percentage of change in ADCs and the change of the diameters (long, short, and mean) respectively (r=0.641, r=0.633, r=0.549, P<0.05). The mean ADC value of partial response was less than stable disease before and after chemotherapy respectively (P=0.25, P=0.54), but there was not statistical significant differences between them.2. There was a negative correlation between pretreatment ADCs and percentage change of long diameter in PR and SD (r=-0.789, r=-0.632, P<0.05), but there was no correlation between pretreatment ADCs and percentage change of diameters when PR and SD was merged(P>0.05).Conclusion The change of ADCs could sensitively reflect the early change of lung cancer response to chemotherapy and had the potential ability to dynamically monitor the lung cancer response to chemotherapy combined with the morphological measurement. It needs to be comfirmd whether the pre-chemotherapy ADCs has the ability to predict lung cancer response of chemotherapy. |
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