Language
English
Publication Date
3-13-2024
Journal
Radiation Oncology
DOI
10.1186/s13014-024-02425-6
PMID
38481285
PMCID
PMC10936078
PubMedCentral® Posted Date
3-13-2024
PubMedCentral® Full Text Version
Post-print
Abstract
BACKGROUND: Diffusion-weighted magnetic resonance imaging (DWI) provides a measurement of tumor cellularity. We evaluated the potential of apparent diffusion coefficient (ADC) values obtained from post-external beam radiation therapy (EBRT) DWI and prior to brachytherapy (BT) to predict for complete metabolic response (CMR) in bulky cervical cancer.
METHODS: Clinical and DWI (b value = 500 s/mm2) data were obtained from patients undergoing interstitial BT with high-risk clinical target volumes (HR-CTVs) > 30 cc. Volumes were contoured on co-registered T2 weighted images and 90th percentile ADC values were calculated. Patients were stratified by CMR (defined by PET-CT at three months post-BT). Relation of CMR with 90th percentile ADC values and other clinical factors (International Federation of Gynecology and Obstetrics (FIGO) stage, histology, tumor and HR-CTV size, pre-treatment hemoglobin, and age) was assessed both in univariate and multivariate logistic regression analyses. Youden’s J statistic was used to identify a threshold value.
RESULTS: Among 45 patients, twenty-eight (62%) achieved a CMR. On univariate analysis for CMR, only 90th percentile ADC value was significant (p = 0.029) while other imaging and clinical factors were not. Borderline significant factors were HR-CTV size (p = 0.054) and number of chemotherapy cycles (p = 0.078). On multivariate analysis 90th percentile ADC (p < 0.0001) and HR-CTV size (p < 0.003) were highly significant. Patients with 90th percentile ADC values above 2.10 × 10
CONCLUSIONS: Clinical DWI may serve to risk-stratify patients undergoing interstitial BT for bulky cervical cancer.
Keywords
Female, Humans, Uterine Cervical Neoplasms, Positron Emission Tomography Computed Tomography, Brachytherapy, Diffusion Magnetic Resonance Imaging, Cervical cancer, Diffusion weighted imaging, Apparent diffusion coefficient, Interstitial brachytherapy
Published Open-Access
yes
Recommended Citation
Dong, Elizabeth E; Xu, Junqian; Kim, Joo-Won; et al., "Apparent Diffusion Coefficient Values Predict Response to Brachytherapy in Bulky Cervical Cancer" (2024). Faculty and Staff Publications. 3693.
https://digitalcommons.library.tmc.edu/baylor_docs/3693
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