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European Radiology
Published in: European Radiology 1/2018

01-01-2018 | Oncology

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

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

Published in: European Radiology | Issue 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.
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Metadata
Title
Multi-parametric MRI in cervical cancer: early prediction of response to concurrent chemoradiotherapy in combination with clinical prognostic factors
Authors
Wei Yang
Jin Wei Qiang
Hai Ping Tian
Bing Chen
Ai Jun Wang
Jian Guo Zhao
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4989-3

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