Simultaneous changes of magnetic resonance diffusion-weighted imaging and pathological microstructure in locally advanced cervical cancer caused by neoadjuvant chemotherapy.

PURPOSE: To investigate the changes to diffusion-weighted imaging (DWI) correlated with histopathology after neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer (LACC). MATERIALS AND METHODS: Thirty-three patients with LACC were examined with 3T magnetic resonance imaging (MRI) with DWI and apparent diffusion coefficient (ADC) maps. MRIs were performed for each patient at three timepoints: before the first NACT, 2 weeks after the first NACT, and 2 weeks after the second NACT. Uterine cervical specimens were collected at the same timepoints. Specimens were stained for tumor cell density, proliferating cell nuclear antigen (PCNA), and aquaporin 1 (AQP1). Treatment responses were classified as the effective group (complete and partial response) and the ineffective group (stable and progressive disease). RESULTS: The ADC value of the effective group after the first chemotherapy was higher than that before chemotherapy (P = 0.002), and expressions of three pathological indicators (tumor cell density, PCNA, and AQP1) significantly decreased after the first NACT compared with those prechemotherapy (P < 0.001). Changes of PCNA expression were negatively correlated with changes of ADC values after the first NACT in the effective group (r = -0.56, P = 0.03). Changes of cellular density were negatively correlated with changes of ADC values from the time of prechemotherapy to after the second NACT in the effective group (r = -0.51, P = 0.04). CONCLUSION: The ADC change after successful chemotherapy is closely related with cellular characteristics preceding size reduction. ADC may be used as an early imaging biomarker of NACT response in LACC.

Basic T1 Perfusion magnetic resonance imaging evaluation of the therapeutic effect of neoadjuvant chemotherapy in locally advanced cervical cancer.

OBJECTIVE: The objective of this study was to evaluate the dynamic changes of blood perfusion coinciding with tumor regression after neoadjuvant chemotherapy (NACT) in locally advanced cervical cancer (LACC). METHODS: Thirty patients with LACC received conventional 3.0-T magnetic resonance imaging and perfusion-weighted imaging scans at 3 different times (before NACT, 2 weeks after the first NACT, and 2 weeks after the second NACT). Characteristics of time-intensity diagrams and patterns of blood perfusion maps according to the parameter of area under the curve (AUC) were observed. Eight perfusion parameters were compared among 3 time points at 2 different chemotherapy-sensitive groups by the software of Basic T1 Perfusion. RESULTS: The effective chemotherapy rate was 73.3% (22/30). The characteristic of time-intensity diagrams in cervical cancer was a rapid onset with plateau. There were 3 patterns of AUC perfusion maps. The common perfusion map was rich blood supply type in the effective chemotherapy group and peripheral blood supply type in the ineffective chemotherapy group. Four parameter values (relative enhancement, maximum enhancement, wash-in rate, and AUC) were significantly reduced 2 weeks after the second NACT than those before the therapy (P = 0.000; P = 0.009; P = 0.011; and P = 0.000) in the effective chemotherapy group, especially the value of relative enhancement 2 weeks after the first NACT, was obviously decreased compared to that before the therapy (P = 0.042). The value of time to peak 2 weeks after the second NACT was significantly longer than that before the therapy in the effective chemotherapy group (P = 0.001). There were no obvious changes of blood perfusion parameters among the 3 different times in the ineffective chemotherapy group. CONCLUSIONS: Tumor blood perfusion has obviously decreased after effective NACT in the treatment of LACC.

The value of diffusion-weighted magnetic resonance imaging in assessing the response of locally advanced cervical cancer to neoadjuvant chemotherapy.

OBJECTIVE: The objective of this study was to investigate whether magnetic resonance diffusion-weighted imaging (DWI) of locally advanced cervical cancer (LACC) both in the sagittal and axial planes could be used to assess the response of LACC to neoadjuvant chemotherapy (NACT). METHODS: Thirty women with LACC received conventional magnetic resonance imaging and DWI at 3 different times (before NACT, 2 weeks after the first NACT, and 2 weeks after the second NACT). Treatment response was determined according to the change in tumor size 2 weeks after the second NACT, and they were classified as the effective group and the ineffective group. The apparent diffusion coefficients (ADCs) were compared between 2 imaging planes, and dynamic changes in ADCs were observed in different chemotherapy-sensitive groups and imaging planes. One-way analysis of variance was calculated between those ADC parameters and tumor response. RESULTS: The effective chemotherapy rate was 76.67%. Apparent diffusion coefficient values of the axial plane at 3 different times were 0.88 (SD, 0.08) × 10⁻³ mm²/s, 0.96 (SD, 0.10) × 10⁻³ mm²/s, and 1.19 (SD, 0.11) × 10⁻³ mm²/s, respectively. Meanwhile, ADC values of the sagittal planes were 0.89 (SD, 0.09) × 10⁻³ mm²/s, 0.97 (SD, 0.12) × 10⁻³ mm²/s, and 1.19 (SD, 0.12) × 10⁻³ mm²/s at 3 different stages. There were no statistical differences between the ADC values of the 2 planes at 3 different times (P = 0.927, P = 0.863, P = 0.946). Apparent diffusion coefficients 2 weeks after the first NACT were significantly increased compared with those before chemotherapy both in the axial and sagittal planes (P = 0.003, P = 0.012). In the ineffective group, ADCs 2 weeks after the first NACT were not statistically higher than those before chemotherapy (axial planes, P = 0.694; sagittal planes, P = 0.900). After 2 weeks of the first NACT, ADCs in both planes were obviously increased in the effective group than those in the ineffective group (P = 0.043, P = 0.022). CONCLUSIONS: The axial and sagittal DWI may detect the changes in LACC after therapy. Apparent diffusion coefficient values measured both in the 2 planes may be used to evaluate the response of LACC to NACT.

[Functional magnetic resonance imaging of brain of college students with internet addiction].

OBJECTIVE: To explore the functional locations of brain regions related to internet addiction (IA)with task-functional magnetic resonance imaging (fMRI). METHODS: Nineteen college students who had internet game addition and 19 controls accepted the stimuli of videos via computer. The 3.0 Tesla MRI was used to record the Results of echo plannar imaging. The block design method was used. Intragroup and intergroup analysis Results in the 2 groups were obtained. The differences between the 2 groups were analyzed. RESULTS: The internet game videos markedly activated the brain regions of the college students who had or had no internet game addiction. Compared with the control group, the IA group showed increased activation in the right superior parietal lobule, right insular lobe, right precuneus, right cingulated gyrus, and right superior temporal gyrus. CONCLUSION: Internet game tasks can activate the vision, space, attention and execution center which are composed of temporal occipital gyrus and frontal parietal gyrus. Abnormal brain function and lateral activation of the right brain may exist in IA.

[Measurement of intracranial hematoma volume by personal computer].

OBJECTIVE: To explore the method for intracranial hematoma volume measurement by the personal computer. METHODS: Forty cases of various intracranial hematomas were measured by the computer tomography with quantitative software and personal computer with Photoshop CS3 software, respectively. the data from the 2 methods were analyzed and compared. RESULTS: There was no difference between the data from the computer tomography and the personal computer (P>0.05). CONCLUSION: The personal computer with Photoshop CS3 software can measure the volume of various intracranial hematomas precisely, rapidly and simply. It should be recommended in the clinical medicolegal identification.

[Motor cortex by real-time imaging process functional MRI during finger movements].

OBJECTIVE: To explore the techniques of RTIP-fMRI scanning and the correspondence between structure and functional changes of motor cortex during self-paced finger movements by RTIP-fMRI in normal volunteers. METHODS: The 15 healthy volunteers were studied by RTIP-fMRI, and the activation tasks consisted of self-paced finger movements performed with the right and the left hands. Image postprocessing was done on the workstation by "correlation coefficient" algorithm analysis method, IAC and SPM software. RESULTS: There was a good correspondence between the anatomical landmarks of the somatotopical organization of primary motor areas in the 15 volunteers; during the finger tasks, the functional changes occurred in the contralateral primary motor-somatosensory cortex (M1/S1), the supplementary motor area (SMA), and the ipsilateral primary motor cortex. CONCLUSION: RTIP, a promising new technique, can localize the motor cortex accurately. It is superior to any other fMRI techniques, and may be used widely in the function research of the brain.