Diffusion-weighted MRI in residual foci evaluation of uterine cervical cancer after chemoradiation therapy / 实用放射学杂志

ABSTRACT

Objective To evaluate the usefulness of diffusion-weighted MR combined with routine T2 WI in finding the possible residual foci in uterine cervical cancers after radical chemo-radiation therapy.Methods This was a retrospective study including 25 consecutive cervical cancer patients who received hysterectomy after radical chemo-radiation therapy.All of them underwent MR examinations post-chemoradiation and just before operation.Images of T2 WI alone and those of T2 WI combining DWI were evaluated respectively by 2 senior radiologists,in order to decide whether there were residual tumors.ADC values were also measured.Taking the post-operation pathological results as the gold standard,the accuracies,sensitivities and specificities of T2 WI alone,T2 WI combining DWI,and ADC values were all calculated.Results In those 25 patients,9 were found with foci of residual cancer in operative pathology,while no cancer cells were found in the other 1 6 patients.The accuracy,sensitivity and specificity in finding the positive residual cancer using T2 WI alone were 56.0%,77.8% and 43.8%,comparing with 72.0%,66.7% and 75.0% in T2 WI combining DWI.The accuracy and specificity increased with statistical significance after combining DWI (P =0.01 6 for accuracy,P =0.031 for specificity),while the sensitivity decreased but did not reach statistically significant level (P =0.099).No difference in ADC values was found.Conclusion DWI can be used as a supplementary sequence in finding the existence of residual tumors of cervical cancer after radical chemo-radiation therapy.Routine T2 WI combing DWI increased the specificity and accuracy,but still facing the risk of decreasing sensitivity.