Diffusion-weighted Imaging In Predicting And Monitori Ng The Response Of Advanced Cervical Cancer To Combined Radiotherapy

Objective To analyze the diffusion weighted imaging （DWI） features of normaluterine cervix and cervical carcinoma before and after radiotherapy， assess the valuesof DWI in monitor of cervical carcinoma after radiotherapy，and measure the apparentdiffusion coefficient （ADC） value in cervical cancer and correlated with pathology．Methods Routine magnetic resonance imaging （MRI） sequence and axial diffusionweighted sequence （b=700s/mm²） were performed in45patients with cervicalcarcinoma and in15healthy women as control. The apparent diffusion coefficient（ADC） values of normal uterine cervix and cervical carcinoma before and afterradiotherapy were compared. The ADC values in different pathologic categories ofcervical cancer, and different differentiation of squamous cancer were also compared.Results1. The ADC value was significantly higher in normal uterine cervix than in cervicalcarcinoma[（1.762±0.119）×10^-3mm²/s vs.（0.891±0.130）×10^-3mm²/s， t=20.199，P<0.05]．2. After radiotherapy the ADC value of cervical carcinoma was higher than thatbefore radiotherapy [（1.670±0.120）×10^-3mm²/s vs.（0.891±0.130）×10^-3mm²/s，t=25.889，P=0.00]， but was still lower than that of normal uterine cervix[（1.762±0.119）×10^-3mm²/s] and ectogluteus[（1.480±0.117）×10^-3mm²/s]． 3. The ADC value was significantly higher in ectogluteus than in cervical carcinoma[（0.891±0.130）×10^-3mm²/s vs.（1.540±0.107）×10^-3mm²/s，t=3.188,P=0.002]. TheADC value of ectogluteus before and after radiotherapy has no difference.4. The ADC value in41patients of squamous cancer and4patients of non-squamouscancer were （0.889±0.129）×10^-3mm²/s and （1.007±0.299）×10^-3mm²/s respectively，without statistically significant difference between these two kinds of cervicalcancer （t=1.544，P=0.130）.5. The ADC value of9cases of well-differentiated，21cases of moderatelydifferentiated and11patients of poorly differentiated squamous cancer were（1.029±0.130）×10^-3mm²/s，（0.844±0.850）×10^-3mm²/s,（0.862±0.128）×10^-3mm²/srespectively， with statistically significant difference between these threegroups（F=10.105，P<0.05）.Conclusions DWI could be used to distinguish cervical carcinoma from normaluterine cervix, and monitor the treatment response of cervical carcinoma afterradiotherapy. Th study manifest that the ADC value has relevance to differentpathologic categories and different differentiation of cervical cancers. Except theADC value of normal cervical., the ADC value of ectogluteus can be used to judgewhether the ADC value of cervical neoplasm is abnormal.