Diffusion magnetic resonance in cervical carcinoma. The role of apparent diffusion coefficient in the evaluation of treatment response

Purpose: The aim of the study was to determinate the role of apparent diffusion coefficient (ADC) in order to find cut-off values in the evaluation of treatment response. Materials and Methods: A retrospective study was undertaken on MRIs of three groups of patients: 17 with histologically proven cervical carcinoma (group 1), 16 with complete regression after chemo-radiotherapy (group 2), and 46 without pathology (group 3). Three non-overlapping ROIs were manually drawn through neoplastic tissue and normal cervical areas,. regions of interest (ROIs) median values were calculated. Student t-test, ANOVA test, receiver operating characteristic (ROC) curves, and Youden Index were performed. Results: The most important data was obtained by ROC curve and Youden index calculated between free from disease merged group (groups 2+3) and ill patients (group 1): 1.18 x10-3mm2/s (94% sensibility,100% specificity), was the cut-off ADC value. Values below this cut-off could be considered as recurrent pathology with high accuracy. Conclusions: ADC represents a fundamental quantitative tool in follow-up of chemo-radiant treatment response in advanced cervical carcinoma.