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CC BY-NC-ND 4.0 · Indian J Radiol Imaging
DOI: 10.1055/s-0045-1807721
Original Article

Quantitative Diffusion and Perfusion MRI as Response Predictor in Cervical Squamous Cell Carcinoma Treated with CCRT

Rajat Nandi
1   Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Ritu Misra
1   Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Neha Bagri 
1   Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Saritha Shamsunder
2   Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Charanjeet Ahluwalia
3   Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
› Author Affiliations
Funding None.
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Abstract

Purpose

This article evaluates the treatment response to chemoradiotherapy in locally advanced cervical squamous cell carcinoma using quantitative diffusion and perfusion magnetic resonance imaging (MRI) parameters and studies their role as response predictors.

Materials and Methods

Patients diagnosed with locally advanced squamous cell carcinoma cervix (LASCC) and planned for concurrent chemoradiotherapy (CCRT) were included. Diffusion-weighted imaging (DWI) and perfusion MRI were performed both pre- and post-CCRT. Statistical analysis of quantitative DWI (apparent diffusion coefficient [ADC]) and perfusion MRI parameters (Ktrans, Kep, Ve, Vp, SImax, SIrel, and time-to-peak) was done to assess the tumor regression rate and compare them between the residual and nonresidual groups.

Results

All the MR perfusion parameters showed statistically significant results (p < 0.05) for the evaluation of the treatment response of LASCC to CCRT using the obtained cutoff values, except for Vp. The highest diagnostic performance was of pretreatment Kep with a sensitivity of 100%, specificity of 80%, positive predictive value of 54.5%, negative predictive value of 100%, area under the curve of 0.833, and diagnostic accuracy of 74.2%. However, ADC values did not show any significant result for the evaluation of the treatment response of LASCC.

Conclusion

Quantitative MR perfusion parameters have a significant role in evaluating treatment response to CCRT in LASCC.

Keywords

chemoradiotherapy - cervical carcinoma - diffusion - perfusion - MRI

Data Availability Statement

The cases and images are available from the Department of Radiodiagnosis, Vardhman Mahavir Medical College, and Safdarjung Hospital, New Delhi, India.


Authors' Contributions

N.B., the corresponding author, designed and revised the work, interpreted the data, and submitted the case. N.B. has approved the submitted version for publication. N.B. has drafted the work and approved the submitted version for publication. R.M. has revised the manuscript and approved the submitted version for publication. R.M. and R.N. have revised the work. S.S. provided the subjects for the study. C.A. provided the histopathology of all patients. All authors read and approved the final manuscript.


Patients' Consent

Written approval was obtained from the patients.




Publication History

Article published online:
04 June 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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