Predictive and prognostic value of intravoxel incoherent motion (IVIM) MR imaging in patients with advanced cervical cancers undergoing concurrent chemo-radiotherapy

By using the intravoxel incoherent motion (IVIM) model, the diffusion-related coefficient (D) and the perfusion-related parameter (f) can be obtained simultaneously. Here, we explored the application of IVIM MR imaging in predicting long-term prognosis in patients with advanced cervical cancers treated with concurrent chemo-radiotherapy (CCRT). In this study, pelvic MR examinations including an IVIM sequence were performed on 30 women with advanced cervical cancers at three time points (within 2 weeks before, as well as 2 and 4 weeks after, the initiation of CCRT). The performance of tumour size and IVIM-derived parameters in predicting long-term prognosis was evaluated. After a median follow-up of 24 months (range, 10∼34 months), 25/30 (83.33%) patients were alive, and 21/30 (70.00%) remained free of disease. A shrinkage rate of maximum diameter (time point 1 vs. 3) ≥ 58.31% was useful in predicting a good long-term prognosis. The IVIM-derived apparent diffusion coefficient (ADC(IVIM)) value at time point 2 and the ADC(IVIM) and f values at time point 3 also performed well in predicting a good prognosis, with AUC of 0.767, 0.857 and 0.820, respectively. IVIM MR imaging has great potential in predicting long-term prognosis in patients with advanced cervical cancers treated with CCRT.