Evaluation Of Interventional Chemotherapy Embolization In Patients With Cervical Cancer Using Diffusion-weighted MR Imaging

Purpose To investigate the changes in apparent diffusion coefficients（ADCs）ofcervical cancer patients receiving interventional chemotherapy embolization, and to assessthe relationship between tumor ADCs or changes in tumor ADCs and tumor responses totherapy.Methods Forty-four patients with cervical cancer who received interventionalchemotherapy embolization were examined with1.5Tesla （T） MRI includingdiffusion-weighted imaging（DWI） with diffusion factor of700and1500s/mm2andT2-weighted imaging（T2WI）. All patients had five serial MR examinations: before therapy;2,5,10,15days after therapy. At each examination, ADC was measured in tumors and normalgluteus muscles. Tumor response as determined by change in tumor size using MRI wascorrelated with tumor ADCs at each time after therapy or changes in tumor ADCs.Results Each time about monitoring therapy, mean tumor ADCs （b=700s/mm2）were0.97±0.11、1.07±0.18、1.24±0.13、1.35±0.12、1.41±1.17×10-3mm2/s in sequence.There wassignificant difference between every adjacent time（p<0.05）,but no significant differencebetween10d and15d（p=0.122）. Mean tumor ADCs（b=1500s/mm2）were0.79±0.09、0.84±0.15、0.95±0.13、1.04±0.16、1.14±0.17×10-3mm2/s, every adjacent time had significantdifference（p<0.05）.The ADCs of normal gluteus muscles between every adjacent timehad no significant difference（P>0.05）. Tumor size and changes in tumor size at every timewere3.86±1.15、3.36±1.12、2.94±1.12、2.45±1.08、2.25±1.00cm and12.95%、24.54%、37.32%、43.27%in sequence. There was only no significant difference between10d and15d （p<0.05）. Tumor ADCs and changes in tumor ADCs（b=1500s/mm2）had significantcorrelation with tumor size responses between10d and15d（p=0.001，r=-0.726）.Conclusion The interventional chemotherapy embolization has positive effect. DWImay have potentials in evaluating the therapeutic response to interventional chemotherapyembolization in patients with cervical cancer.The day of ten after therapy initiated can beconsidered as the optimal time for monitoring the early treatment response of uterine cervicalcancer to interventional chemotherapy embolization.