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European Radiology
Erschienen in: European Radiology 1/2018

04.08.2017 | Oncology

Multi-parametric MRI in cervical cancer: early prediction of response to concurrent chemoradiotherapy in combination with clinical prognostic factors

verfasst von: Wei Yang, Jin Wei Qiang, Hai Ping Tian, Bing Chen, Ai Jun Wang, Jian Guo Zhao

Erschienen in: European Radiology | Ausgabe 1/2018

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Abstract

Objective

To investigate the prediction of response to concurrent chemoradiotherapy (CCRT) through a combination of pretreatment multi-parametric magnetic resonance imaging (MRI) with clinical prognostic factors (CPF) in cervical cancer patients.

Methods

Sixty-five patients underwent conventional MRI, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI) before CCRT. The patients were divided into non- and residual tumour groups according to post-treatment MRI. Pretreatment MRI parameters and CPF between the two groups were compared and prognostic factors, optimal thresholds, and predictive performance for post-treatment residual tumour occurrence were estimated.

Results

The residual group showed a lower maximum slope of increase (MSIL) and signal enhancement ratio (SERL) in low-perfusion subregions, a higher apparent diffusion coefficient (ADC) value, and a higher stage than the non-residual tumour group (p < 0.001, p = 0.003, p < 0.001, and p < 0.001, respectively). MSIL and ADC were independent prognostic factors. The combination of both measures improved the diagnostic performance compared with individual MRI parameters. A further combination of these two factors with CPF exhibited the highest predictive performance.

Conclusions

Pretreatment MSIL and ADC were independent prognostic factors for cervical cancer. The predictive capacity of multi-parametric MRI was superior to individual MRI parameters. The combination of multi-parametric MRI with CPF further improved the predictive performance.

Key points

• Pretreatment MSI L and ADC were independent prognostic factors for post-treatment residual tumours.
• The residual groups showed lower MSI L , higher ADC and higher stage.
• The predictive capacity of multi-parametric MRI was superior to individual MRI parameters.
• The combination of multi-parametric MRI with CPF exhibited the highest predictive performance.
Literatur
1.
2.
Chereau E, DE LA Hosseraye C, Ballester M et al (2013) The role of completion surgery after concurrent radiochemotherapy in locally advanced stages IB2-IIB cervical cancer. Anticancer Res 33:1661–1666PubMed
3.
Leguevaque P, Motton S, Delannes M et al (2011) Completion surgery or not after concurrent chemoradiotherapy for locally advanced cervical cancer? Eur J Obstet Gynecol Reprod Biol 155:188–192CrossRefPubMed
4.
Tangjitgamol S, Katanyoo K, Laopaiboon M, Lumbiganon P, Manusirivithaya S, Supawattanabodee B (2014) Adjuvant chemotherapy after concurrent chemoradiation for locally advanced cervical cancer. Cochrane Database Syst Rev 12: (Cd010401)
5.
Sun Y, Tong T, Cai S, Bi R, Xin C, Gu Y (2014) Apparent diffusion coefficient (ADC) value:a potential imaging biomarker that reflects the biological features of rectal cancer. Plos One 9, e109371CrossRefPubMedPubMedCentral
6.
Kuang F, Ren J, Zhong Q, Fu LY, Huan Y, Chen ZQ (2013) The value of apparent diffusion coefficient in the assessment of cervical cancer. Eur Radiol 23:1050–1058CrossRefPubMed
7.
Liu Y, Ye ZX, Sun HR, Bai RJ (2015) Clinical application of diffusion-weighted magnetic resonance imaging in uterine cervical cancer. Int J Gynecol Cancer 25:1073–1078CrossRefPubMed
8.
Somoye G, Harry V, Semple S et al (2012) Early diffusion weighted magnetic resonance imaging can predict survival in women with locally advanced cancer of the cervix treated with combined chemo-radiation. Eur Radiol 22:2319–2327CrossRefPubMed
9.
Kim HS, Kim CK, Park BK, Huh SJ, Kim B (2013) Evaluation of therapeutic response to concurrent chemoradiotherapy in patients with cervical cancer using diffusion-weighted MR imaging. J Magn Reson Imaging 37:187–193CrossRefPubMed
10.
Gladwish A, Milosevic M, Fyles A et al (2016) Association of apparent diffusion coefficient with disease recurrence in patients with locally advanced cervical cancer treated with radical chemotherapy and radiation therap. Radiology 279:158–166CrossRefPubMed
11.
Harry VN (2010) Novel imaging techniques as response biomarkers in cervical cancer. Gynecol Oncol 116:253–261CrossRefPubMed
12.
Kim JH, Kim CK, Park BK, Park SY, Huh SJ, Kim B (2012) Dynamic contrast-enhanced 3-T MR imaging in cervical cancer before and after concurrent chemoradiotherapy. Eur Radiol 22:2533–2539CrossRefPubMed
13.
Loncaster JA, Carrington BM, Sykes JR et al (2002) Prediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix. Int J Radiat Oncol Biol Phys 54:759–767CrossRefPubMed
14.
Pecorelli S, Zigliani L, Odicino F (2009) Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet 105:107–108CrossRefPubMed
15.
Semple SI, Harry VN, Parkin DE, Gilbert FJ (2009) A combined pharmacokinetic and radiologic assessment of dynamic contrast-enhanced magnetic resonance imaging predicts response to chemoradiation in locally advanced cervical cancer. Int J Radiat Oncol Biol Phys 75:611–617CrossRefPubMed
16.
Yamashita Y, Baba T, Baba Y et al (2000) Dynamic contrast-enhanced MR imaging of uterine cervical cancer: pharmacokinetic analysis with histopathologic correlation and its importance in predicting the outcome of radiation therapy. Radiology 216:803–809CrossRefPubMed
17.
Nam H, Park W, Huh SJ et al (2007) The prognostic significance of tumor volume regression during radiotherapy and concurrent chemoradiotherapy for cervical cancer using MRI. Gynecol Oncol 107:320–325CrossRefPubMed
18.
Odicino F, Tisi G, Rampinelli F, Miscioscia R, Sartori E, Pecorelli S et al (2007) New development of the FIGO staging system. Gynecol Oncol 107:S8–S9CrossRefPubMed
19.
Sevin BU, Lu Y, Bloch DA, Nadjl M, Koechill DR, Averette HE (1996) Surgically defined prognostic parameters in patients with early cervical carcinoma a multivariate survival tree analysis. Cancer 78:1438–1446CrossRefPubMed
20.
Takeda N, Sakuragi N, Takeda M et al (2002) Multivariate analysis of histopathologic prognostic factors for invasive cervical cancer treated with radical hysterectomy and systematic retroperitoneal lymphadenectomy. Acta Obstet Gynecol Scand 81:1144–1151CrossRefPubMed
21.
Lyng H, Vorren AO, Sundfor K et al (2001) Intra- and intertumor heterogeneity in blood perfusion of human cervical cancer before treatment and after radiotherapy. Int J Cancer 96:182–190CrossRefPubMed
22.
Dzik-Jurasz A, Domenig C, George M et al (2002) Diffusion MRI for prediction of response of rectal cancer to chemoradiation. Lancet 360:307–308CrossRefPubMed
23.
McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA (2008) Diffusion-weighted MRI in cervical cancer. Eur Radiol 18:1058–1064CrossRefPubMed
24.
Huang ZB, Mayr NA, Lo SS et al (2013) Characterizing at-risk voxels by using perfusion magnetic resonance imaging for cervical cancer during radiotherapy. J Cancer Sci Ther 4:254–259
25.
Mayr NA, Yuh WTC, Jajoura D et al (2010) Ultra-early predictive assay for treatment failure using functional magnetic resonance imaging and clinical prognostic parameters in cervical cancer. Cancer 116:903–912CrossRefPubMedPubMedCentral
26.
Kilic S, Cracchiolo B, Gabel M, Haffty B, Mahmoud O (2015) The relevance of molecular biomarkers in cervical cancer patients treated with radiotherapy. Ann Transl Med 18:261
27.
Fu Z, Chen D, Cheng H, Wang F (2015) Hypoxia-inducible factor-1alpha protects cervical carcinoma cells from apoptosis induced by radiation via modulation of vascular endothelial growth factor and p53 under hypoxia. Med Sci Monit 21:318–325CrossRefPubMedPubMedCentral
28.
Zahra MA, Hollingsworth KG, Sala E, Lomas DJ, Tan LT (2007) Dynamic contrast-enhanced MRI as a predictor of tumour response to radiotherapy. Lancet Oncol 8:63–74CrossRefPubMed
29.
Mayr NA, Hawighorst H, Yuh WTC, Essig M, Magnotta VA, Knopp MV (1999) MR microcirculation in cervical cancer: correlations with histomorphological tumor markers and clinical outcome. J Magn Reson Imaging 10:267–276CrossRefPubMed
30.
Taylor JS, Tofts PS, Port RE et al (1999) MR imaging of tumor microcirculation: promise for the new millennium. J Magn Reson Imaging 10:903–907CrossRefPubMed
31.
Li YL, Zhang XP, Li J et al (2015) MRI in diagnosis of pathological complete response in breast cancer patients after neoadjuvant chemotherapy. Eur J Radiol 84:242–249CrossRefPubMed
32.
Wu ML, Lu L, Zhang Q et al (2016) Relating doses of contrast agent administered to TIC and semi-quantitative parameters on DCE-MRI: based on a murine breast tumor model. Plos One 11, e0149279CrossRefPubMedPubMedCentral
33.
Zahra MA, Tan LT, Priest AN et al (2009) Semi-quantitative and quantitative dynamic contrast-enhanced magnetic resonance imaging measurements predict radiation response in cervix cancer. Int J Radiat Oncol Biol Phys 74:766–773CrossRefPubMed
Metadaten
Titel
Multi-parametric MRI in cervical cancer: early prediction of response to concurrent chemoradiotherapy in combination with clinical prognostic factors
verfasst von
Wei Yang
Jin Wei Qiang
Hai Ping Tian
Bing Chen
Ai Jun Wang
Jian Guo Zhao
Publikationsdatum
04.08.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 1/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4989-3

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