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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(01): 25-32
DOI: 10.4103/ijri.IJRI_441_18
Womens Imaging

Role of apparent diffusion coefficient as a biomarker in the evaluation of cervical cancer

Sunita Dashottar
Departments of Radiology and Imaging, Lucknow, Uttar Pradesh, India
,
T Preeth Pany
Departments of Radiology and Imaging, Lucknow, Uttar Pradesh, India
,
Nishant Lohia
Radiation Oncology, Command Hospital (Central Command), Lucknow, Uttar Pradesh, India
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Subject Editor: Financial support and sponsorship Nil.
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Abstract

Background: Diffusion-weighted magnetic resonance imaging (DW-MRI) has evolved as a major diagnostic and prognostic tool in cervical cancer. The aim of our study was to compare the change in mean apparent diffusion coefficient (ADC) value before and after concurrent chemoradiation therapy (CCRT) in carcinoma cervix thereby establishing its role as a cancer biomarker. Materials and Methods: A hospital-based prospective study was conducted in 35 patients diagnosed with cervical cancer. All 35 patients underwent pelvic MRI before and after 6 months of CCRT. The study was done over a period of 12 months. Conventional axial and sagittal T2 imaging was followed by DW-MRI. In the axial DW/ADC images at “b-value” of 800 s/mm2, a circular region of interest was drawn covering more than 60% of the tumor volume to calculate the ADC values. Statistical Package for the Social Sciences (version 21.0) was used for statistical evaluation. Chi-square test, independent samples t-test, and analysis of variance were used to analyze the data. The results are depicted as frequencies (number), proportion (percentages), and mean ± standard deviation. Results: Pre-CCRT mean ADC value was 0.814 × 10−3 mm2/s. Post-CCRT mean ADC value was 1.294 × 10−3 mm2/s. Mean ADC value of patients having lymph node involvement and parametrial extension was significantly lower when compared with those without lymph node involvement and parametrial extension (P = 0.001). Nonresponders with residual lesion had lower ADC values than responders with no residual lesion. An interesting and unique observation was that pre-CCRT mean ADC value of responders was higher than nonresponders. Conclusion: An increase in mean ADC value of 0.480 × 10−3 mm2/s after CCRT was found to be statistically significant (P < 0.001) thereby proving its role as an imaging biomarker in cancer cervix.

Keywords

Apparent diffusion coefficient - cervical cancer - concurrent chemoradiation therapy - diffusion-weighted magnetic resonance imaging


Publication History

Article published online:
23 July 2021

© 2019. 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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