Abstract：Objective To investigate the application value of introvoxel incoherent motion (IVIM)-MRI in evaluation of curative effect of radical concurrent chemoradiotherapy for cervical cancer. Methods A total of 67 patients with middle and advanced cervical cancer diagnosed and treated in the Affiliated Hospital of North China University of Science and Technology from February 2019 to June 2021 were collected, all subjects received concurrent chemoradiotherapy. Routine MRI, diffusion weighted imaging (DWI) and IVIM were performed within three days before treatment (before treatment), treatment for three weeks (in the treatment), and three days after treatment (after treatment). Patients whose tumor volume decreased by more than 1/3 after treatment compared with before treatment were included in the treatment sensitive group, and the rest were treatment non-sensitive group. The tumor regression rate was calculated; image parameters and parameter change rate at different time points were compared between two groups; the correlation between imaging parameters and tumor regression rate was analyzed. Results Before treatment, the apparent diffusion coefficient (ADC) value, diffusion coefficient (D) value and false diffusion coefficient (D*) value of treatment sensitive group were higher than those of treatment non-sensitive group (P < 0.05); in the treatment, ADC value, D value, D* value, and perfusion score (f) value in treatment sensitive group were higher than those in treatment non-sensitive group (P < 0.05); after treatment, ADC value, D value, and f value in treatment sensitive group were higher than those in treatment non-sensitive group (P < 0.05). In the treatment and after treatment, the change rate of ADC value, D value, and f value in treatment sensitive group was higher than those in treatment non-sensitive group (P < 0.05). The tumor regression rate of 67 patients was (66.3±24.8)%. Before treatment, ADC value and f value were positively correlated with tumor regression rate (r > 0, P < 0.05); in the treatment, the change rate of ADC value and D value were positively correlated with tumor regression rate (r > 0, P < 0.05); after treatment, the change rate of ADC value and D value were positively correlated with tumor regression rate (r > 0, P < 0.05). Conclusion IVIM parameters and their change rate have certain guiding significance for evaluating the effect of radical concurrent chemoradiotherapy for middle and advanced cervical cancer.
李伟兰 谢宗源 王雅静 李晖 陈伟彬 王志强 张惠英. IVIM-MRI在宫颈癌根治性同步放化疗效果评价中的应用价值[J]. 中国医药导报, 2022, 19(19): 160-163.
LI Weilan XIE Zongyuan WANG Yajing LI Hui CHEN Weibin WANG Zhiqiang ZHANG Huiying. Application value of IVIM-MRI in evaluation of curative effect of radical concurrent chemoradiotherapy for cervical cancer. 中国医药导报, 2022, 19(19): 160-163.
[1] Torre LA，Islami F，Siegel RL，et al. Global Cancer in Women：Burden and Trends [J]. Cancer Epidemiol Biomarkers Prev，2017，26（4）：444-457.
[2] 周晖，白守民，林仲秋.《2019 NCCN宫颈癌临床实践指南（第1版）》解读[J].中国实用妇科与产科杂志，2018， 34（9）：1002-1009.
[3] Zhang H，Zhou Y，Li J，et al. The value of DWI in predicting the response to synchronous radiochemotherapy for advanced cervical carcinoma：Comparison among three mathematical models [J]. Cancer Imaging，2020，20（1）：8.
[4] Song J，Hu Q，Ma Z，et al. Value of diffusion-weighted and dynamic contrast-enhanced MR in predicting parametrial invasion in cervical stromal ring focally disrupted stage ⅠB-ⅡA cervical cancers [J]. Abdom Radiol（NY），2019，44（9）：3166-3174．
[5] Doudou NR，Liu Y，Kampo S，et al. Optimization of intravoxel incoherent motion （IVIM）：variability of parameters measurements using a reduced distribution of b values for breast tumors analysis [J]. MAGMA，2020，33（2）：273-281.
[6] Vidi■ I，Egnell L，Jerome NP，et al. Modeling the diffusion-weighted imaging signal for breast lesions in the b=200 to 3000 s/mm2 range：quality of fit and classification accuracy for different representations [J]. Magn Reson Med，2020，84（2）：1011-1023.
[7] Zhu G，Heit JJ，Martin BW，et al. Optimized Combination of b-values for IVIM Perfusion Imaging in Acute Ischemic Stroke Patients [J]. Clin Neuroradiol，2020，30（3）：535-544.
[8] 刘荫华，刘倩.客观解读RECIST（修订版）的临床评价意义[J].中国实用外科杂志，2010，30（1）：31-33.
[9] Fabian D，LaRocco A，Olsen M，et al. Treatment of locally advanced cervical cancer in a patient with a bicornuate uterus with MRI-guided intracavitary/interstitial brachytherapy [J]. J Contemp Brachytherapy，2019，11（3）：285-291.
[10] 杨蔚，杨妍，何剑莉，等.功能MRI联合临床预后因素预测同步放化疗治疗宫颈鳞癌疗效[J].中国医学影像技术，2020，36（3）：433-438.
[11] 冉仪婷，卑贵光.体素内不相干运动成像及微血管密度与宫颈癌病理分级的相关性研究[J].磁共振成像，2021，12（7）：72-76.
[12] 李乃玉，高飞，董江宁，等.体素内不相干运动扩散加权成像参数值与子宫颈鳞癌病理分化相关性初步研究[J].中国医学计算机成像杂志，2018，24（6）：515-520.
[13] Gao S，Du S，Lu Z，et al. Multiparametric PET/MR （PET and MR-IVIM） for the evaluation of early treatment response and prediction of tumor recurrence in patients with locally advanced cervical cancer [J]. Eur Radiol，2020，30（2）：1191-1201.
[14] 佟晶，卑贵光，李玉泽，等.体素内不相干运动成像和动态增强磁共振成像在子宫颈癌病理分级中的诊断价值[J].中国医科大学学报，2019，48（12）：1112-1117.
[15] 武小鹏，吴慧，高阳，等.IVIM双指数及拉伸指数模型评估宫颈癌放化疗疗效的价值[J].放射学实践，2019， 34（7）：792-796.
[16] Abdel Razek AAK. Editorial for “Preliminary Assessment of Intravoxel Incoherent Motion Diffusion-Weighted MRI（IVIM-DWI）Metrics in Alzheimer’s Disease”[J]. J Magn Reson Imaging，2020，52（6）：1827-1828.
[17] Jalnefjord O，Montelius M，Arvidsson J，et al. Data-driven identification of tumor subregions based on intravoxel incoherent motion reveals association with proliferative activity [J]. Magn Reson Med，2019，82（4）：1480-1490.
[18] 张蕊，白岩，魏巍，等.体素内不相干运动成像和扩散峰度成像基本原理及其在中枢神经系统疾病中的应用[J].磁共振成像，2020，11（9）：804-808.
[19] Sun J，Wu G，Shan F，et al. The Value of IVIM DWI in Combination with Conventional MRI in Identifying the Residual Tumor After Cone Biopsy for Early Cervical Carcinoma [J]. Acad Radiol，2019，26（8）：1040-1047.
[20] Chabert S，Verdu J，Huerta G，et al. Impact of b-Value Sampling Scheme on Brain IVIM Parameter Estimation in Healthy Subjects [J]. Magn Reson Med Sci，2020，19（3）：216-226.
[21] 陈翠云，王梅云，朱庆尧，等.循环miR-143水平在宫颈癌患者同步放化疗后肿瘤残留的早期预测[J].中华放射肿瘤学杂志，2021，30（9）：910-916.
[22] 米红兰，程杰军，殷霞，等.体素不相干运动与动态对比增强磁共振成像在评估早期宫颈癌淋巴脉管浸润状态中的应用[J].上海交通大学学报（医学版），2020，40（2）：224-230.
[23] 徐洋，肖华，姜山山，等.阿帕替尼联合放化疗对中晚期宫颈癌患者临床治疗的影响[J].中华老年医学杂志，2021， 40（9）：1165-1168.
[24] 樊雪娇，毕建蕾，林琳，等.新辅助化疗联合手术治疗ⅡB期宫颈癌患者的疗效及其影响因素分析[J].中华妇幼临床医学杂志（电子版），2021，17（1）：99-105.
[25] 冯静，林建海，廖绍光，等.宫颈癌术后调强放疗中骨髓抑制与骨髓照射剂量体积的关系[J].国际放射医学核医学杂志，2020，44（3）：143-150.
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