University of Twente Student Theses
Tumour microenvironment changes in locally advanced cervical cancer: IVIM-DWI evaluation of diffusion and perfusion during chemoradiation or thermoradiotherapy
Rooy, E.A. van (2025) Tumour microenvironment changes in locally advanced cervical cancer: IVIM-DWI evaluation of diffusion and perfusion during chemoradiation or thermoradiotherapy.
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| Abstract: | Purpose – Hyperthermia enhances the radiosensitivity of locally advanced cervical cancer (LACC) through distinct mechanisms compared to chemotherapy. This study aimed to quantify diffusion coefficient (D) and perfusion-related fraction (f) measured by intravoxel incoherent motion (IVIM) diffusion weighted (DW) magnetic resonance imaging (MRI) in the tumour regions of LACC patients and evaluate changes in these parameters during treatment with chemoradiation (CCRT) or thermoradiotherapy (TRT). Methodology – LACC patients underwent 3.0T IVIM-DW MRI before treatment (pre-RT), at week 3 (mid-RT) and 3 months after treatment (post-RT). TRT patients were scanned immediately before and after the TRT session in week 1 and week 3. D and f were estimated using a non-segmented least squares fitting approach and quantified in the tumour region delineated after fitting. Results were evaluated for all patients and grouped by complete response to treatment, partial response to treatment, stable disease and progressive disease. Results – Twelve CCRT patients and one TRT patient were included. D and f showed an increasing trend between pre- and mid-CCRT of 19.6% and 21.6% respectively. One patient with progressive disease had a decrease in f of -86.2%. In the TRT patient, D and f increased by 9.1% and 32.3% between pre- and mid-TRT. Immediately after a TRT session, D remained stable and f increased from 5.4% to 7.6% in week 1 and from 8.5% to 10.0% in week 3. Conclusions – The preliminary findings show an increasing trend in both D and f in the LACC tumour region during CCRT or TRT, and an increase in f after a TRT session. These findings represent a first step towards understanding how tumour perfusion contributes to the enhanced radiosensitivity of hyperthermia compared to chemotherapy. Keywords - Chemoradiation, IVIM-DW MRI, locally advanced cervical cancer, perfusion related fraction, thermoradiotherapy |
| Item Type: | Essay (Master) |
| Clients: | AmsterdamUMC, Amsterdam, The Netherlands |
| Faculty: | TNW: Science and Technology |
| Subject: | 33 physics, 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/106728 |
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