局部晚期宫颈癌 (LACC) 的体素内不相干运动 (IVIM) MR 定量：评估肿瘤侵袭性和新辅助化疗反应的初步研究

Twenty patients with biopsy-proven cervical cancer, staged as LACC on baseline MRI and addressed for neoadjuvant chemotherapy were enrolled. At treatment completion, tumor response was assessed with a follow-up MRI evaluated using the revised response evaluation criteria in solid tumors (RECIST; version 1.1), and patients were considered good responders (GR) if they had complete response or partial remission, and poor responders/non-responders (PR/NR) if they had stable or progressive disease. MRI protocol included conventional diffusion-weighted imaging (DWI; b = 0 and 1000 s/mm 2 ) and IVIM acquisition using eight b-values (range: 0-1500 s/mm 2 ). MR-images were analyzed using a dedicated software to obtain quantitative parameters: diffusion (D), pseudo-diffusion (D*), and perfusion fraction (fp) from the IVIM model; apparent diffusion coefficient (ADC) from conventional DWI. Histologic subtype, grading, and tumor-infiltrating lymphocytes (TILs) were assessed in each LACC.

D showed significantly higher values in GR patients ( p = 0.001) and in moderate/high TILs ( p = 0.018). Fp showed significantly higher values in squamous cell tumors ( p = 0.006).

D extracted from the IVIM model could represent a promising tool to identify tumor aggressiveness and predict response to therapy.