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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 6/2021

01-06-2021 | Brachytherapy | Original Article

Prediction of treatment response in patients with locally advanced cervical cancer using midtreatment PET/MRI during concurrent chemoradiotherapy

Authors: Radovan Vojtíšek, MD, PhD, Ass. Prof. Jan Baxa, MD, PhD, Petra Kovářová, MD, Amira Almortaza, MD, Petr Hošek, MSc., PhD, Emília Sukovská, MD, Radek Tupý, MD, MSc., PhD, Prof. Jiří Ferda, MD, PhD, Prof. Jindřich Fínek, MD, PhD, MHA

Published in: Strahlentherapie und Onkologie | Issue 6/2021

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Abstract

Purpose

We aimed to find metabolic, functional or morphological characteristics of the tumor predicting failure to achieve complete metabolic remission (CMR) by the midtreatment PET/MRI (positron emission tomography/magnetic resonance imaging) in cervical cancer patients.

Methods

We evaluated 66 patients treated between August 2015 and November 2019 who underwent pretreatment staging, subsequent midtreatment evaluation, and definitive restaging 3 months after completing the whole treatment, all using PET/MRI. The pretreatment parameters (pre-SUVmax, pre-SUVmean, pre-MTV, pre-MTV‑S, pre-TLG, pre-TLG‑S [SUV: standard uptake value, MTV: metabolic tumor volume, TLG: total lesion glycolysis]), and the midtreatment parameters at week 5 during chemoradiotherapy (mid-SUVmax, mid-SUVmean, mid-MTV, mid-MTV‑S, mid-TLG and mid-TLG-S) were recorded. The value of ADC (apparent diffusion coefficient) was also measured. Furthermore, we recorded absolute and relative changes in all parameters—∆ and ∆%. We divided the whole group of patients into “responders” (CMR) and “non-responders” (non-CMR), and compared them on the basis of the parameters from pre-PET/MRI and mid-PET/MRI.

Results

A statistically significant difference in the evaluated parameters between responders and non-responders was found for the following parameters: mid-MTV, mid-TLG, mid-TLG‑S, mid-MTV‑S, mid-tumor size, and ∆%SUVmax. According to the ROC (receiver operating characteristic) analysis, mid-MTV‑S showed the best albeit moderate discrimination ability for the prediction of non-CMR. Significant mutual correlations of all variables, in particular between mid-MTV‑S and mid-TLG‑S and between mid-MTV and mid-TLG, were found (all p < 0.05).

Conclusion

Our study confirmed that when using the midtreatment PET/MRI we are able to identify metabolic parameters having the discrimination ability for the prediction of non-CMR. In particular mid-MTV‑S, mid-MTV, mid-tumor size, mid-TLG‑S, mid-TLG and ∆%SUVmax.
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Metadata
Title
Prediction of treatment response in patients with locally advanced cervical cancer using midtreatment PET/MRI during concurrent chemoradiotherapy
Authors
Radovan Vojtíšek, MD, PhD
Ass. Prof. Jan Baxa, MD, PhD
Petra Kovářová, MD
Amira Almortaza, MD
Petr Hošek, MSc., PhD
Emília Sukovská, MD
Radek Tupý, MD, MSc., PhD
Prof. Jiří Ferda, MD, PhD
Prof. Jindřich Fínek, MD, PhD, MHA
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 6/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-020-01740-7

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