Prognostic value of diffusion-weighted magnetic resonance imaging and ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography after concurrent chemoradiotherapy in uterine cervical cancer.

Abstract

To evaluate the prognostic value of diffusion-weighted imaging (DWI) and positron emission tomography/computed tomography (PET/CT) for predicting disease progression after concurrent chemoradiotherapy (CCRT) in cervical cancer. A total of 67 locally advanced cervical cancer patients who received CCRT underwent both DWI and PET/CT before and during (at 1month) treatment. The mean apparent diffusion coefficient (ADC_mean) and maximum standardized uptake value (SUV_max) were measured on the tumor and the percentage changes between 2 time points (ΔADC_mean and ΔSUV_max) were calculated. The ΔADC_mean and ΔSUV_max were compared in terms of predicting disease progression after CCRT. During a mean follow-up of 2.7years, disease progression was identified in 16 patients (23.9%). The ΔADC_mean and ΔSUV_max were significantly correlated (Spearman correlation coefficient, 0.38; P=0.002). For predicting disease progression, the integrated area under the curves of ΔADC_mean (0.791) and ΔSUV_max (0.781) were not significantly different (P=0.88). On multivariate analysis, both ΔADC_mean and ΔSUV_max were the independent predictors of disease progression (hazard ratio, 7.9 and 8.7; P, 0.001 and <0.001, respectively). The percentage changes of ADC_mean and SUV_max during CCRT have a similar prognostic value for predicting disease progression after CCRT in cervical cancers.