Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Pre-Treatment Diffusion-Weighted MR Imaging for Predicting Tumor Recurrence in Uterine Cervical Cancer Treated with Concurrent Chemoradiation: Value of Histogram Analysis of Apparent Diffusion Coefficients

  • Heo, Suk Hee (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Shin, Sang Soo (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Jin Woong (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Lim, Hyo Soon (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Jeong, Yong Yeon (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Kang, Woo Dae (Department of Obstetrics and Gynecology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Kim, Seok Mo (Department of Obstetrics and Gynecology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Kang, Heoung Keun (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School)
  • Received : 2012.12.18
  • Accepted : 2013.04.24
  • Published : 2013.07.01
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Abstract

Objective: To evaluate the value of apparent diffusion coefficient (ADC) histogram analysis for predicting tumor recurrence in patients with uterine cervical cancer treated with chemoradiation therapy (CRT). Materials and Methods: Our institutional review board approved this retrospective study and waived informed consent from each patient. Forty-two patients (mean age, 56 ${\pm}$ 14 years) with biopsy-proven uterine cervical squamous cell carcinoma who underwent both pre-treatment pelvic magnetic resonance imaging with a 3.0 T magnetic resonance scanner and concurrent CRT were included. All patients were followed-up for more than 6 months (mean, 36.4 ${\pm}$ 11.9 months; range 9.0-52.8 months) after completion of CRT. Baseline ADC parameters (mean ADC, 25th percentile, 50th percentile, and 75th percentile ADC values) of tumors were calculated and compared between the recurrence and no recurrence groups. Results: In the recurrence group, the mean ADC and 75th percentile ADC values of tumors were significantly higher than those of the no recurrence group (p = 0.043 and p = 0.008, respectively). In multivariate analysis, the 75th percentile ADC value of tumors was a significant predictor for tumor recurrence (p = 0.009; hazard ratio, 1.319). When the cut-off value of the 75th percentile ADC ($0.936{\times}10^{-3}mm^2/sec$) was used, the overall recurrence free survival rate above the cut-off value was significantly lower than that below the cut-off value (51.9% vs. 91.7%, p = 0.003, log-rank test). Conclusion: Pre-CRT ADC histogram analysis may serve as a biomarker for predicting tumor recurrence in patients with uterine cervical cancer treated with CRT.

Keywords

References

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