Role Of Apparent Diffusion Coefficient In Predicting Risk Factors And Recent Curative Effect Afterconcurrent Chemo-radiotherapy Forcervical Squamous Cell Carcinoma

Objective:To explore the role of apparent diffusion coefficient(ADC)in predicting risk factors and recent curative effect after concurrent chemo-radiotherapy for cervical squamous cell carcinoma.Methods:52 patients with squamous cell carcinoma cervix who received radical radio-chemotherapy in Suzhou Municipal Hospital during August 2013 to August 2016 were included.Conventional magnetic resonance(MR)and diffusion-weighted MR imaging were underwent prior to therapy and one month after the therapy initiated.The value of ADCmean was measured at each examination.Tumor response was determined according to the response evaluation criteria in solid tumors(RECIST)one month after the treatment.The subjects were classified as two groups:responders and non-responders groups.The correlations of ADC values with tumor staging,tumor size,lymphatic metastasis and recent curative effect were investigated.Results:The mean value of the preoperative ADCmean was(719.48 ± 72.74)*10-6mm~2/s,which was significantly lower than the data measured one month after the therapy initiated(P<0.001).The average increase of mid-ADCmean was(299.73±126.39)*10-6mm~2/s compared to pre-ADCmean,with a ratio of 43.3%(9.36%-133.41%).The mean value of pre-ADCmean in the lymph node metastasis group was(692.78±68.74)*10-6mm~2/s,which was obviously lower than the non-lymph node metastasis group(P=0.001).However,there was no statistical significance between pre-ADCmean and clinical stage as well as tumor size.All mid-ADCmean,AADCmean and ?ADCmean%were significantly higher in responders group than non-responders group(P<0.001 and P=0.02 and P<0.001).Though pre-ADCmean was of no significance between them(P=0.86).Conclusion:1.Radical concurrent chemo-radiotherapy for cervical squamous cell carcinoma could cause a significant increase in ADCmean.2.The mean value of pre-ADCmean in the lymph node metastasis group was obviously lower than the non-lymph node metastasis group,while there was no statistical significance between pre-ADCmean and clinical stage as well as tumor size.3.Pre-ADCmean was of no significance between responders group and non-responders group.4.All mid-ADCmean,?ADCmean and ?ADCmean%were significantly higher in responders group than non-responders group.