Cervical cancer apparent diffusion coefficient values during external beam radiotherapy
Background and purpose: Apparent diffusion coefficient (ADC) reflects micro-enviromental changes and therefore might be useful in predicting recurrence prior to brachytherapy. The purpose of this study is to evaluate change in ADC of the primary tumour and pathologic lymph nodes during treatment and...
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doaj-9b4c82e1a3724a509dc2e17b59426ab72020-11-24T21:05:40ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162019-01-0197782Cervical cancer apparent diffusion coefficient values during external beam radiotherapyPeter de Boer0Stefano Mandija1Anita M. Werensteijn-Honingh2Cornelis A.T. van den Berg3Astrid A.C. de Leeuw4Ina M. Jürgenliemk-Schulz5Department of Radiation Oncology, University Medical Centre Utrecht, The Netherlands; Department of Radiation Oncology, Amsterdam University Medical Centres (Amsterdam UMC) – University of Amsterdam (UvA), The Netherlands; Corresponding author at: Dept. of Radiation Oncology, Amsterdam UMC, UvA, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.Centre for Image Sciences, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The NetherlandsDepartment of Radiation Oncology, University Medical Centre Utrecht, The NetherlandsCentre for Image Sciences, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The NetherlandsDepartment of Radiation Oncology, University Medical Centre Utrecht, The NetherlandsDepartment of Radiation Oncology, University Medical Centre Utrecht, The NetherlandsBackground and purpose: Apparent diffusion coefficient (ADC) reflects micro-enviromental changes and therefore might be useful in predicting recurrence prior to brachytherapy. The purpose of this study is to evaluate change in ADC of the primary tumour and pathologic lymph nodes during treatment and to correlate this with clinical outcome. Material and methods: Twenty patients were included who received chemoradiation for locally advanced cervical cancer between July 2016 and November 2017. All patients underwent magnetic resonance imaging (MRI) prior to treatment, and three MRIs in weeks 1/2, 3 and 4 of treatment, including T2 and diffusion weighted imaging (b-values 0, 200, 800 s/mm2) for determining an ADC-map. Primary tumour was delineated on T2 and ADC-map and pathologic lymph nodes were delineated only on ADC-map. Results: At time of analysis median follow-up was 15 (range 7–22) months. From MRI one to four, primary tumour on ADC-map showed a significant signal increase of 0.94 (range 0.74–1.46) × 10−3 mm2/s to 1.13 (0.98–1.49) × 10−3 mm2/s (p < 0.001). When tumour was delineated on T2, ADC-value signal increase (in tumour according to T2) was similar. All 46 delineated pathologic lymph nodes showed an ADC-value increase on average from 0.79 (range 0.33–1.12) × 10−3 mm2/s to 1.14 (0.59–1.75) × 10−3 mm2/s (p < 0.001). The mean tumour/suspected lymph node volumes decreased respectively 51/40%. Four patients developed relapse (one local and three nodal), without clear relation with ΔADC. However, the median volume decrease of the primary tumour was substantially lower in the failing patients compared to the group without relapse (19 vs. 57%). Conclusions: ADC values can be acquired using T2-based tumour delineations unless there are substantial shifts between ADC-mapping and T2 acquisition. It remains plausible that ΔADC is a predictor for response to EBRT. However, the correlation in this study was not statistically significant. Keywords: Cervical cancer, ADC map, MRIhttp://www.sciencedirect.com/science/article/pii/S2405631618300770 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Peter de Boer Stefano Mandija Anita M. Werensteijn-Honingh Cornelis A.T. van den Berg Astrid A.C. de Leeuw Ina M. Jürgenliemk-Schulz |
spellingShingle |
Peter de Boer Stefano Mandija Anita M. Werensteijn-Honingh Cornelis A.T. van den Berg Astrid A.C. de Leeuw Ina M. Jürgenliemk-Schulz Cervical cancer apparent diffusion coefficient values during external beam radiotherapy Physics and Imaging in Radiation Oncology |
author_facet |
Peter de Boer Stefano Mandija Anita M. Werensteijn-Honingh Cornelis A.T. van den Berg Astrid A.C. de Leeuw Ina M. Jürgenliemk-Schulz |
author_sort |
Peter de Boer |
title |
Cervical cancer apparent diffusion coefficient values during external beam radiotherapy |
title_short |
Cervical cancer apparent diffusion coefficient values during external beam radiotherapy |
title_full |
Cervical cancer apparent diffusion coefficient values during external beam radiotherapy |
title_fullStr |
Cervical cancer apparent diffusion coefficient values during external beam radiotherapy |
title_full_unstemmed |
Cervical cancer apparent diffusion coefficient values during external beam radiotherapy |
title_sort |
cervical cancer apparent diffusion coefficient values during external beam radiotherapy |
publisher |
Elsevier |
series |
Physics and Imaging in Radiation Oncology |
issn |
2405-6316 |
publishDate |
2019-01-01 |
description |
Background and purpose: Apparent diffusion coefficient (ADC) reflects micro-enviromental changes and therefore might be useful in predicting recurrence prior to brachytherapy. The purpose of this study is to evaluate change in ADC of the primary tumour and pathologic lymph nodes during treatment and to correlate this with clinical outcome. Material and methods: Twenty patients were included who received chemoradiation for locally advanced cervical cancer between July 2016 and November 2017. All patients underwent magnetic resonance imaging (MRI) prior to treatment, and three MRIs in weeks 1/2, 3 and 4 of treatment, including T2 and diffusion weighted imaging (b-values 0, 200, 800 s/mm2) for determining an ADC-map. Primary tumour was delineated on T2 and ADC-map and pathologic lymph nodes were delineated only on ADC-map. Results: At time of analysis median follow-up was 15 (range 7–22) months. From MRI one to four, primary tumour on ADC-map showed a significant signal increase of 0.94 (range 0.74–1.46) × 10−3 mm2/s to 1.13 (0.98–1.49) × 10−3 mm2/s (p < 0.001). When tumour was delineated on T2, ADC-value signal increase (in tumour according to T2) was similar. All 46 delineated pathologic lymph nodes showed an ADC-value increase on average from 0.79 (range 0.33–1.12) × 10−3 mm2/s to 1.14 (0.59–1.75) × 10−3 mm2/s (p < 0.001). The mean tumour/suspected lymph node volumes decreased respectively 51/40%. Four patients developed relapse (one local and three nodal), without clear relation with ΔADC. However, the median volume decrease of the primary tumour was substantially lower in the failing patients compared to the group without relapse (19 vs. 57%). Conclusions: ADC values can be acquired using T2-based tumour delineations unless there are substantial shifts between ADC-mapping and T2 acquisition. It remains plausible that ΔADC is a predictor for response to EBRT. However, the correlation in this study was not statistically significant. Keywords: Cervical cancer, ADC map, MRI |
url |
http://www.sciencedirect.com/science/article/pii/S2405631618300770 |
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