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

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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Abbreviations

MRI:

magnetic resonance imaging

DWI:

diffusion-weighted imaging

ADC:

apparent diffusion coefficient

DCE-MRI:

dynamic contrast-enhanced MRI

MSI:

maximum slope of increase

SER:

signal enhancement ratio

ROI:

region of interest

CPF:

clinical prognostic factor

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Jin Wei Qiang.

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Guarantor

The scientific guarantor of this publication is Jin Wei Qiang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by National Natural Science Foundation of China (No.81471628); Shanghai Municipal Commission of Health and Family Planning, China (No.2013SY075 and No. ZK2015A05).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was obtained from all patients in this study.

Methodology

• prospective

• diagnostic or prognostic study

• performed at one institution.

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Yang, W., Qiang, J.W., Tian, H.P. et al. Multi-parametric MRI in cervical cancer: early prediction of response to concurrent chemoradiotherapy in combination with clinical prognostic factors. Eur Radiol 28, 437–445 (2018). https://doi.org/10.1007/s00330-017-4989-3

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  • DOI: https://doi.org/10.1007/s00330-017-4989-3

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