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ORIGINAL ARTICLE
Year : 2019  |  Volume : 10  |  Issue : 3  |  Page : 141-146

Changes in magnetic resonance imaging parameters and chemo-radiotherapy response among cervical cancer patients attending a regional cancer center of North India


1 Department of Radiation Oncology, Sarvodaya Hospital and Research Center, Sector 8, Faridabad, Haryana, India
2 Department of Radiation Oncology, MM Institute of Medical Sciences, Mullana, Haryana, India
3 Department of Radiation Oncology, AIIMS, Rishikesh, Uttarakhand, India
4 Department of Radiodiagnosis, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
5 Department of Community Medicine, ESIC Medical College and Hospital, Faridabad, India

Correspondence Address:
Dr. Divya Gupta
Department of Radiation Oncology, Sarvodaya Hospital and Research Center, Sector 8, Faridabad, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrcr.jrcr_19_19

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Objective: This study was planned to evaluate the effectiveness of dynamic contrast-enhanced magnetic resonance and diffusion-weighted imaging techniques in evaluating tissue hypoxia and thus develop an early predictor of treatment response in cervical cancer. Materials and Methods: This prospective study was conducted at a regional cancer center of North India from 2013 to 2014. It was conducted among locally advanced carcinoma cervix patients. Magnetic resonance imaging (MRI) was carried out at three time points, namely, prior to commencement of, after 2 weeks of start, and after 4–5 weeks of chemo-radiotherapy. A total of 48 MRI scans were performed. Change in dynamic contrast perfusion parameters (Ktrans, Kep, Ve, and IAUC) and values of apparent diffusion coefficient (ADC) between different time points was calculated. Results: A total of 19 patients underwent 48 MRI scans. The percentage tumor volume regression (PTR) between the first and third MRI volumes ranged from 36.9% to 100%. The percentage diameter regression calculated between the first and third MRI ranged from 10% to 100%. The tumor volume and diameter reduced significantly from pre- to post-treatment. As compared to pretreatment parameters, it was observed that the values of Ve, IAUC, and ADC demonstrated an increase from baseline to the subsequent MRI; however, Kepand Ktransshowed an opposite trend. Conclusion: A higher value of Ktransis associated with a better tumor response to treatment. These changes can help in predicting response to therapy.


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