Prognostic value of diffusion-weighted magnetic resonance imaging and 18F-fluorodeoxyglucose-positron emission tomography/computed tomography after concurrent chemoradiotherapy in uterine cervical cancer

Abstract

Purpose To evaluate the prognostic value of diffusion-weighted imaging (DWI) and positron emission tomography/computed tomography (PET/CT) for predicting disease progression after concurrent chemoradiotherapy (CCRT) in cervical cancer. Materials and methods A total of 67 locally advanced cervical cancer patients who received CCRT underwent both DWI and PET/CT before and during (at 1 month) treatment. The mean apparent diffusion coefficient (ADCmean) and maximum standardized uptake value (SUVmax) were measured on the tumor and the percentage changes between 2 time points (ΔADCmean and ΔSUVmax) were calculated. The ΔADCmean and ΔSUVmax were compared in terms of predicting disease progression after CCRT. Results During a mean follow-up of 2.7 years, disease progression was identified in 16 patients (23.9%). The ΔADCmean and ΔSUVmax were significantly correlated (Spearman correlation coefficient, 0.38; P = 0.002). For predicting disease progression, the integrated area under the curves of ΔADCmean (0.791) and ΔSUVmax (0.781) were not significantly different (P = 0.88). On multivariate analysis, both ΔADCmean and ΔSUVmax were the independent predictors of disease progression (hazard ratio, 7.9 and 8.7; P, 0.001 and <0.001, respectively). Conclusion The percentage changes of ADCmean and SUVmax during CCRT have a similar prognostic value for predicting disease progression after CCRT in cervical cancers.