Value of apparent diffusion coefficient (ADC) in assessing radiotherapy and chemotherapy success in cervical cancer

被引:52
作者
Fu, Zhan-Zhao [1 ]
Peng, Yong [2 ]
Cao, Li-Yan [1 ]
Chen, Yan-Sheng [3 ]
Li, Kun [4 ]
Fu, Bao-Hong [1 ]
机构
[1] First Hosp Qinhuangdao, Dept Oncol, Qinhuangdao 066000, Peoples R China
[2] Yanshan Univ, Dept Bioengn, Qinhuangdao 066000, Peoples R China
[3] First Hosp Qinhuangdao, Div NMR Res, Qinhuangdao 066000, Peoples R China
[4] Yanshan Univ, Dept Chem Engn, Qinhuangdao 066000, Peoples R China
关键词
Diffusion-weighted MR imaging; Apparent diffusion coefficient; Cervical cancer; Radiotherapy; Chemotherapy; Meta-analysis; WEIGHTED MRI; CHEMORADIOTHERAPY; CARCINOMA; TUMOR; CHEMORADIATION; METAANALYSIS; PREDICTION; BIOMARKER;
D O I
10.1016/j.mri.2015.02.002
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objective: We investigated the clinical significance of apparent diffusion coefficient (ADC) values in diffusion-weighted magnetic resonance imaging (DWI) in monitoring the efficacy of radiotherapy (RT) and chemotherapy (CT) treatments in cervical cancer. Method: In order to identify relevant high quality clinical cohort studies reporting the use of DWI in cervical cancers, the following electronic databases in English and Chinese languages were comprehensively searched: MEDLINE, Science Citation Index database, Cochrane Library Database, PubMed, Embase, CINAHI, and Current Contents Index; Chinese Biomedical Database, Chinese Journal Full-Text Database. All selected studies were published prior to March 2014, and data extracted from these studies were analyzed using STATA 12.0 statistical software. Results: We initially retrieved 196 articles (79 Chinese articles and 117 English articles) through database searches and finally selected sixteen cohort studies for this meta-analysis. The 16 studies contained a combined total of 517 subjects, and all selected studies reported the mean ADC value (10(-3) mm(2)/s) in DWI in cervical cancer patients treated with RT and CT. Combined standardized mean difference (SMD) suggested that the mean post-RT and mean post-CT ADC values were significantly higher than the mean pre-RT and mean pre-CT ADC values, respectively, in cervical cancer patients (SMD = 2.95, 95% CI = 2.19-3.72, P < 0.001). Ethnicity-stratified analysis revealed that increased ADC values were observed post-RT and post-CT in both Caucasian (SMD = 1.44, 95% CI = 0.93-1.95, P < 0.001) and Asian populations (SMD = 3.32, 95% CI = 2.42-422, P < 0.001), compared with the mean ADC values before RT and CT, respectively, in the two subgroups. Further, subgroup analysis based on b-value revealed that higher ADC values were found in cervical cancer patients after RT and CT, compared to before RT and CT treatment, with both b value 900 (SMD = 3.71, 95% CI = 2.35-5.07, P < 0.001) and >900 (SMD = 2.55, 95% CI = 1.78-3.32, P < 0.001). The mean ADC value in patients without residual tumor post-RI and post-CT treatment was significantly higher than seen in patients with residual tumors (SMD = 0.80, 95% CI = 0.49-1.12, P < 0.001). Conclusion: Our meta-analysis revealed a significant correlation between mean ADC values and the clinical response to RI and CT treatment Thus, ADC values in DWI may be effective in evaluating the clinical outcome of treatments in cervical cancer patients. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:516 / 524
页数:9
相关论文
共 46 条
[1]   Diffusion-Weighted Magnetic Resonance Imaging as a Cancer Biomarker: Consensus and Recommendations [J].
不详 .
NEOPLASIA, 2009, 11 (02) :102-125
[2]   Double Burden of Noncommunicable and Infectious Diseases in Developing Countries [J].
Bygbjerg, I. C. .
SCIENCE, 2012, 337 (6101) :1499-1501
[3]  
Cao K, 2009, CHIN J MED IMAGING T, P1657
[4]  
Cui G, 2013, CHIN J CLIN ELECTRON, V7, P7573
[5]   Liver lesion detection and characterization: Role of diffusion-weighted imaging [J].
Galea, Nicola ;
Cantisani, Vito ;
Taouli, Bachir .
JOURNAL OF MAGNETIC RESONANCE IMAGING, 2013, 37 (06) :1260-1276
[6]  
Gao Y, 2013, ANHUI MED PHARM J, V17, P967
[7]   Diffusion magnetic resonance imaging: A biomarker for treatment response in oncology [J].
Hamstra, Daniel A. ;
Rehemtulla, Alnawaz ;
Ross, Brian D. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (26) :4104-4109
[8]   Diffusion-weighted magnetic resonance imaging in the early detection of response to chemoradiation in cervical cancer [J].
Harry, Vanessa N. ;
Semple, Scott I. ;
Gilbert, Fiona J. ;
Parkin, David E. .
GYNECOLOGIC ONCOLOGY, 2008, 111 (02) :213-220
[9]   Novel imaging techniques as response biomarkers in cervical cancer [J].
Harry, Vanessa N. .
GYNECOLOGIC ONCOLOGY, 2010, 116 (02) :253-261
[10]  
Hu AM, 2012, J WENZHOU MED COLL, V42, P474