Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

// Jie Meng 1 , Lijing Zhu 2 , Li Zhu 1 , Li Xie 2 , Huanhuan Wang 1 , Song Liu 1 , Jing Yan 2 , Baorui Liu 2 , Yue Guan 3 , Jian He 1 , Yun Ge 3 , Zhengyang Zhou 1 and Xiaofeng Yang 4 1 Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China 2 The Comprehensive Cancer Centre of Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China 3 School of Electronic Science and Engineering, Nanjing University, Nanjing, 210046, China 4 Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia 30322, USA Correspondence to: Jian He, email: hjxueren@126.com Yun Ge, email: geyun@nju.edu.cn Zhengyang Zhou, email: zyzhou@nju.edu.cn Keywords: diffusion weighted imaging, magnetic resonance imaging, uterine cervical neoplasms, histogram analysis, texture analysis Received: June 19, 2017     Accepted: August 28, 2017     Published: September 28, 2017 ABSTRACT Purpose: To explore the value of whole-lesion apparent diffusion coefficient (ADC) histogram and texture analysis in predicting tumor recurrence of advanced cervical cancer treated with concurrent chemo-radiotherapy (CCRT). Methods: 36 women with pathologically confirmed advanced cervical squamous carcinomas were enrolled in this prospective study. 3.0 T pelvic MR examinations including diffusion weighted imaging (b = 0, 800 s/mm 2 ) were performed before CCRT (pre-CCRT) and at the end of 2nd week of CCRT (mid-CCRT). ADC histogram and texture features were derived from the whole volume of cervical cancers. Results: With a mean follow-up of 25 months (range, 11 ~ 43), 10/36 (27.8%) patients ended with recurrence. Pre-CCRT 75th, 90th, correlation, autocorrelation and mid-CCRT ADC mean , 10th, 25th, 50th, 75th, 90th, autocorrelation can effectively differentiate the recurrence from nonrecurrence group with area under the curve ranging from 0.742 to 0.850 (P values range, 0.001 ~ 0.038). Conclusions: Pre- and mid-treatment whole-lesion ADC histogram and texture analysis hold great potential in predicting tumor recurrence of advanced cervical cancer treated with CCRT.