The Value of Diffusion-Weighted Magnetic Resonance Imaging in Predicting the Efficacy of Radiation and Chemotherapy in Cervical Cancer

Background: To analyze the application value of apparent diffusion coefficient (ADC) and exponent apparent diffusion coefficient (EADC) in evaluating the efficacy of radiation and chemotherapy in cervical cancer using pre- and posttreatment diffusion-weighted magnetic resonance imaging (DW-MRI) scans. Methods: 52 patients with cervical cancer were administered radiation and chemotherapy. Both MRI and DW-MRI were obtained at different stages. The ADC and EADC values, as well as the maximum tumor diameter, were measured and analyzed. Results: We found that the ADC value increased after treatment, and the EADC value decreased. Changes in the calculated ADC occurred earlier than the morphologic changes of the tumors. A negative correlation was detected between reduced rates in the maximum tumor diameter two months after treatment and pretreatment ADC value (r = -0.658, P < 0.05). An ROC curve and nonlinear regression analysis showed that the formula, y = (1525500.122x(2) - 4689.962x + 3.482) x 100%, can be used to calculate the percentage of complete remission after treatment according to the pretreatment ADC value. Conclusion: Our data suggest that pretreatment ADC and EADC values are predictive of the efficacy of radiation and chemotherapy. Both ADC and EADC values during treatment were instrumental in early monitoring and dynamic observation.