Assessment of early response to concurrent chemoradiotherapy in cervical cancer: Value of diffusion-weighted and dynamic contrast-enhanced MR imaging

Purpose: To investigate diffusion-weighted (DWI) and dynamic contrast-enhanced MR imaging (DCE-MRI) as early response predictors in cervical cancer patients who received concurrent chemoradiotherapy (CCRT). Materials and methods: Sixteen patients with cervical cancer underwent DWI and DCE-MRI before CCRT (preTx), at 1. week (postT1) and 4. weeks (postT2) after initiating treatment, and 1. month after the end of treatment (postT3). At each point, apparent diffusion coefficient (ADC) and DCE-MRI parameters were measured in tumors and gluteus muscles (GM). Tumor response was correlated with imaging parameters or changes in imaging parameters at each point. Results: At each point, ADC, K^trans and V_e in tumors showed significant changes (P<. 0.05), as compared with those of GM (P>. 0.05). PostT1 tumor ADCs showed a significant correlation with tumor size response at postT2 (P= 0.041), and changes in tumor ADCs at postT1 had a significant correlation with tumor size (P= 0.04) and volume response (P= 0.003) at postT2. In tumors, preTx K^trans and V_e showed significant correlations with tumor size at postT3 (P= 0.011) and tumor size response at postT2 (P= 0.019), respectively.