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La radiologia medica

, Volume 121, Issue 11, pp 838–846 | Cite as

Evaluation of diffusion-weighted imaging (DWI) and MR spectroscopy (MRS) as early response biomarkers in cervical cancer patients

  • Stefania RizzoEmail author
  • Valentina Buscarino
  • Daniela Origgi
  • Paul Summers
  • Sara Raimondi
  • Roberta Lazzari
  • Fabio Landoni
  • Massimo Bellomi
DIAGNOSTIC IMAGING IN ONCOLOGY

Abstract

Purpose

To prospectively assess whether choline levels and Apparent Diffusion Coefficient (ADC) values within cervical cancers before, during, and after non-surgical therapy are predictive of tumour response.

Patients and methods

Patients undergoing MR examination for staging of cervical cancer, candidate for non-surgical therapy, were prospectively enrolled. According to the status at the end of therapies, patients were divided into responders and non-responders. The final outcome after a 5-year follow-up was classified as No Evidence of Disease (NED) or Progression of Disease (PD). Baseline values of mean ADC and Cho/H2O were compared between responders and non-responders, as well as between patients with NED and PD. The percent variation of ADC and Cho/H2O values over time was compared. P values <0.05 were considered significant.

Results

16 patients were included. There was no significant difference at baseline between responders (n = 12) and non-responders (n = 4), nor between NED (n = 11) PD patients (n = 5), in ADC values and Cho/H2O ratio. There was no significant difference in percent variation of ADC values and of Cho/H2O, comparing responders and non-responders. There was a significant increase in absolute values of ADC from the initial to mid-therapy MRI (p = 0.0001), while Cho/H2O was stable (p value: 0.61). In the four non-responders, the ADC increase was not significant (p value: 0.25), while it was significant in the 11 responders (p value: 0.001). Values of spectroscopy were stable in both responders and non-responders.

Conclusions

High increases of ADC values from baseline to mid-therapy MR reflect response to therapies. There were no significant variations in choline/water ratios over time.

Keywords

MR spectroscopy DWI Cervical cancer Response biomarkers 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Italian Society of Medical Radiology 2016

Authors and Affiliations

  • Stefania Rizzo
    • 1
    Email author
  • Valentina Buscarino
    • 2
  • Daniela Origgi
    • 3
  • Paul Summers
    • 1
  • Sara Raimondi
    • 4
  • Roberta Lazzari
    • 5
  • Fabio Landoni
    • 6
  • Massimo Bellomi
    • 1
    • 7
  1. 1.Department of RadiologyEuropean Institute of OncologyMilanItaly
  2. 2.Department of Health SciencesUniversity of MilanMilanItaly
  3. 3.Medical PhysicsEuropean Institute of OncologyMilanItaly
  4. 4.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanItaly
  5. 5.Department of RadiotherapyEuropean Institute of OncologyMilanItaly
  6. 6.Department of GynaecologyEuropean Institute of OncologyMilanItaly
  7. 7.Department of OncologyUniversity of MilanMilanItaly

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