Evaluation of various apparent diffusion coefficient measurement techniques in pre-operative staging of early cervical carcinoma

Mongula, Jordy; Bakers, Frans C. H.; Slangen, Brigitte; Kuijk, Sander M. J. van; Mihl, Casper

doi:10.1016/j.ejrad.2019.06.021

Cited by 6 publications

(2 citation statements)

References 37 publications

(58 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bickel et al [ 31 ] concluded that ROI placement significantly affects the ADCs in breast tumors. In many previous studies of cervical cancer, the ADCs were measured on the slice with the largest tumor size using different ROI placement methods, including a single freehand ROI covering the whole tumor, multiple circle-like ROIs of different sizes or three dimensional (3D) -ROIs covering the whole lesion [ 15 , 16 ]. Importantly, the ADCs differed significantly depending on the measurement procedure, a factor that should be recognized when comparing measurements at different times and in prior studies.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Greater increases in intratumoral apparent diffusion coefficients after chemoradiotherapy predict better overall survival of patients with cervical cancer

et al. 2023

View full text Add to dashboard Cite

Purpose To evaluate whether 1) the intratumoral apparent diffusion coefficients (ADCs) change during cervical cancer treatment and 2) the pretreatment ADC values or their change after treatment predict the treatment outcome or overall survival of patients with cervical cancer. Methods We retrospectively enrolled 52 patients with inoperable cervical cancer treated with chemoradiotherapy, who had undergone diffusion weighted MRI before treatment and post external beam radiotherapy (EBRT) and concurrent chemotherapy. A subgroup of patients (n = 28) underwent altogether six consecutive diffusion weighted MRIs; 1) pretreatment, 2) post-EBRT and concurrent chemotherapy; 3–5) during image-guided brachytherapy (IGBT) and 6) after completing the whole treatment course. To assess interobserver and intertechnique reproducibility two observers independently measured the ADCs by drawing freehand a large region of interest (L-ROI) covering the whole tumor and three small ROIs (S-ROIs) in areas with most restricted diffusion. Results Reproducibility was equally good for L-ROIs and S-ROIs. The pretreatment ADCs were higher in L-ROIs (883 mm2/s) than in S-ROIs (687 mm2/s, P < 0.001). The ADCs increased significantly between the pretreatment and post-EBRT scans (L-ROI: P < 0.001; S-ROI: P = 0.001). The ADCs remained significantly higher than pretreatment values during the whole IGBT. Using S-ROIs, greater increases in ADCs between pretreatment and post-EBRT MRI predicted better overall survival (P = 0.018). Conclusion ADC values significantly increase during cervical cancer treatment. Greater increases in ADC values between pretreatment and post-EBRT predicted better overall survival using S-ROIs. Standardized methods for timing and delineation of ADC measurements are advocated in future studies.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, there are no standardized methods for measuring ADCs in patients with cervical cancer. Consequently, various methods have been used to place regions of interest (ROI) [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%