Perbandingan Gambaran Diffusion Weighted Imaging (DWI) dan Nilai Apparent Diffusion Coefficient (ADC) Dengan Kriteria Recist 1.1 pada Pasien Karsinoma Serviks yang Menjalani Radioterapi

YANIE ARYANTY, Prof. Dr. dr. Lina Choridah, Sp.Rad (K)-PRP.; dr. Hesti Gunarti Sp. Rad (K) RA

2025 | Tesis-Spesialis | S2 Radiologi

Latar Belakang: Kanker serviks merupakan salah satu masalah kesehatan yang sangat penting untuk diperhatikan karena memiliki angka morbiditas dan mortalitas tinggi di seluruh dunia. Evaluasi terapi menggunakan modalitas MRI dengan sistem RECIST 1.1 telah secara luas digunakan, tetapi sistem ini dilaporkan memiliki subjektivitas interobserver yang tinggi. Penggunaan sekuens DWI-ADC dilaporkan memiliki kemampuan yang baik dalam menilai respon terhadap kemoradioterapi, sehingga diduga terdapat korelasi antara keduanya.

Metode: Penelitian analitik observasional dengan desain cross sectional. Data diperoleh secara retrospektif, yaitu dengan melakukan analisis ulang gambar MRI pelvis kontras. Dilakukan penilaian RECIST 1.1, gambaran DWI, dan nilai ADC.

Hasil: Penelitian ini menunjukkan bahwa seluruh pasien dengan kriteria Partial Response (PR) menunjukkan gambaran DWI restricted (100,0%), sedangkan seluruh pasien dengan kriteria Complete Response (CR) menunjukkan gambaran DWI non-restricted (100,0%). Perbedaan tersebut signifikan secara statistik (p <0>

Kesimpulan: Terdapat perbedaan signifikan pada gambaran DWI dan nilai ADC antara pasien dengan respons PR dan CR berdasarkan kriteria RECIST 1.1. Perubahan signifikan pada gambaran DWI dan peningkatan nilai ADC setelah terapi menegaskan potensi DWI dan ADC sebagai biomarker untuk evaluasi respons radioterapi pada karsinoma serviks uteri.

Background: Cervical cancer is one of the most important health problems to be considered because it has high morbidity and mortality rates worldwide. Evaluation of therapy using MRI modality with the RECIST 1.1 system has been widely used, but this system is reported to have high interobserver subjectivity. The use of DWI- ADC sequences is reported to have good ability in assessing response to chemoradiotherapy, so it is suspected that there is a correlation between the two.

Methods: Observational analytical study with a cross-sectional design. Data were obtained retrospectively, namely by re-analyzing contrast pelvic MRI images. RECIST 1.1 assessment, DWI images, and ADC values were carried out.

Results: This study showed that all patients with Partial Response (PR) criteria showed restricted DWI images (100.0%), while all patients with Complete Response (CR) criteria showed non-restricted DWI images (100.0%). The difference was statistically significant (p <0>

Conclusion: There were significant differences in DWI images and ADC values between patients with PR and CR responses based on RECIST 1.1 criteria. Significant changes in DWI images and increased ADC values after therapy confirmed the potential of DWI and ADC as biomarkers for evaluating radiotherapy response in uterine cervical carcinoma.

Kata Kunci : karsinoma serviks uteri; DWI; ADC; RECIST, uterine cervical carcinoma