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

  • DIAGNOSTIC IMAGING IN ONCOLOGY
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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.

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Authors and Affiliations

  1. Department of Radiology, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    Stefania Rizzo, Paul Summers & Massimo Bellomi

  2. Department of Health Sciences, University of Milan, Via A.di Rudinì 8, 20142, Milan, Italy

    Valentina Buscarino

  3. Medical Physics, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    Daniela Origgi

  4. Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Adamello 16, 20139, Milan, Italy

    Sara Raimondi

  5. Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    Roberta Lazzari

  6. Department of Gynaecology, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    Fabio Landoni

  7. Department of Oncology, University of Milan, Via Festa del Perdono 7, 20142, Milan, Italy

    Massimo Bellomi

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  1. Stefania Rizzo
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  2. Valentina Buscarino
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Correspondence to Stefania Rizzo.

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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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Rizzo, S., Buscarino, V., Origgi, D. et al. Evaluation of diffusion-weighted imaging (DWI) and MR spectroscopy (MRS) as early response biomarkers in cervical cancer patients. Radiol med 121, 838–846 (2016). https://doi.org/10.1007/s11547-016-0665-y

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  • DOI: https://doi.org/10.1007/s11547-016-0665-y

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