Value Of Diffusion Weighted Imaging And Dynamic Contrast-enhanced Magnetic Resonance Imaging In Predicting The Early Efficacy Of Concurrent Chemoradiotherapy For Cervical Cancer

Part Ⅰ:Value of diffusion weighted imaging in predicting the early efficacy of concurrent chemoradiotherapy for cervical cancerObjective: To explore the value of the apparent diffusion coefficient(ADC)of diffusion-weighted imaging(DWI)as an early effect prediction in cervical cancer treated with concurrent chemoradiotherapy(CCRT)by 3.0T MRI functional imaging.Materials and methods: From July 2016 to September 2017,26 patients with cervical squamous cell carcinomas who planned to be treated in our hospital were recruited for researching.All the patients examined by conventional MRI and DWI before treatment,during treatment(one week after treatment)and at the end of treatment.Data collected includes: the volume and relative ADC(r ADC)of cervical cancer before treatment,during treatment and at the end of treatment;the volume retraction rate of cervical cancer and the change rate of r ADC in cervical lesions during treatment and at the end of treatment.All data are tested for normal distribution,pairs or independent sample t tests were performed for each group of values that meet the normal distribution.Non-parametric tests are performed on the values of each group that do not meet the normal distribution,it was statistically significant that the P value was less than 0.05.Spearman rank correlation analysis was used for correlation analysis.The optimal threshold was determined by the curve of the subject’s working characteristic curve(ROC curve).Results: There was no significant difference in volume of cervical cancer lesions between the complete remission group and the partial remission group before treatment(t =﹣1.005,P=0.325 > 0.05)and in treatment(t =﹣0.888,P=0.536 > 0.05).Also there was no significant difference in volume retraction rate during treatment between the complete remission group and the partial remission group(t = 0.450,P=0.739 > 0.05).In either the complete remission group or the partial remission group,the r ADC value of the cervical cancer lesions showed a significant increase after one week(t=﹣16.76,P<0.001;t=﹣19.19,P<0.001).There was no significant difference in r ADC value between the complete remission group and the partial remission group before treatment(t =﹣1.158,P=0.258 > 0.05)and in treatment(t = 0.089,P=0.930 > 0.05),.In the treatment(t = 2.659,P=0.014 < 0.05),the rate of r ADC change in the cervical cancer lesions between the complete remission group and the partial remission group was statistically significant.The rate of r ADC change of cervical cancer in the treatment was significantly correlated with the volume and volume retraction rate of cervical cancer after treatment(rs=﹣0.683,P<0.001;rs=0.512,P=0.008<0.05).Take the change rate of r ADC in cervical cancer during treatment not less than 25.645% as the cut-off point prediction at the end of the treatment of cervical lesions completely relieve the sensitivity and specificity of 85.7%,68.4% respectively,the area under the curve of 0.805,P=0.019 < 0.05,95% of the confidence interval(CI)is 0.615~0.994.Conclusion: The change rate of r ADC value of cervical cancer in CCRT treatment can predict the residual state of cervical cancer at the end of CCRT treatment,and can be used to predict the early curative effect of CCRT for cervical cancer.Part Ⅱ:Value of dynamic contrast-enhanced magnetic resonance imaging in predicting the early efficacy of concurrent chemoradiotherapy for cervical cancerObjective: To explore the value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)as an early effect prediction in cervical cancer treated with concurrent chemoradiotherapy(CCRT)by 3.0T MRI functional imaging.Materials and methods: From July 2016 to September 2017,26 patients with cervical squamous cell carcinomas who planned to be treated in our hospital were recruited for researching.All the patients examined by DCE-MRI before treatment,conventional MRI and DWI at the end of treatment.Data collected includes: the volume and relative Ktrans(r Ktrans)of cervical cancer before treatment,the volume and volume retraction rate of cervical cancer at the end of treatment.All data are tested for normal distribution,pairs or independent sample t tests were performed for each group of values that meet the normal distribution.Non-parametric tests are performed on the values of each group that do not meet the normal distribution,it was statistically significant that the P value was less than 0.05.Spearman rank correlation analysis was used for correlation analysis.The optimal threshold was determined by the curve of the subject’s working characteristic curve(ROC curve).Results: There was a significant difference in the r Ktrans value of the cervical lesions between the complete remission group and the partial remission group before treatment(t = 2.686,P=0.024 < 0.05).The r Ktrans value of cervical cancer before treatment was significantly correlated with the volume and volume retraction rate of cervical cancer after treatment(rs=﹣0.502,P<0.01;rs=0.779,P<0.001).Take the r Ktrans in cervical cancer before treatment greater than or equal to 12.08 as the cut-off point prediction at the end of the treatment of cervical lesions completely relieve the sensitivity and specificity of 85.7%,63.2% respectively,the area under the curve of 0.816,P=0.015<0.05,95% CI 0.633~0.999.Conclusion: The r Ktrans of cervical cancer before CCRT treatment can predict the residual state of cervical cancer at the end of CCRT treatment,and can be used to predict the early curative effect of CCRT for cervical cancer.