Can diffusion-weighted magnetic resonance imaging predict tumor recurrence of uterine cervical cancer after concurrent chemoradiotherapy?

Bae, Jung Min; Kim, Chan Kyo; Park, Jung Jae; Park, Byung Kwan

doi:10.1007/s00261-016-0730-y

Cited by 17 publications

(17 citation statements)

References 25 publications

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“…However, Heo et al [ 4 ] reported just the opposed results. Somoye et al [ 8 ] and Bae et al [ 9 ] also reported that pre-treatment ADC mean did not show any differences between good and poor long-term prognoses in cervical cancers. This discrepancy may be due to the following explanations: (1) the ROI placement with or without necrotic area in the tumors, while our study drew VOIs of the whole tumor (including cystic and necrotic areas) instead of traditional ROI (only one slice); (2) tumor heterogeneity, while our study contains various ADC histogram and texture parameters which can reflect the tumor heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

“…Fortunately, we found that mid-CCRT ADC mean had a good prognostic value for patients with cervical cancers. Bae et al [ 9 ] also reported that mid-treatment ADC mean was significantly lower in tumor recurrence group and could serve as a useful prognostic biomarker.…”

Section: Discussionmentioning

confidence: 99%

“…It was reported that cervical cancers with lower pre-treatment ADC values were at a higher risk of recurrence [ 6 , 7 ]. And a lower rise of ADC values in early stage of CCRT may help predict a poor prognosis in patients with cervical cancers [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

Meng

Zhu

et al. 2017

Oncotarget

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PurposeTo explore the value of whole-lesion apparent diffusion coefficient (ADC) histogram and texture analysis in predicting tumor recurrence of advanced cervical cancer treated with concurrent chemo-radiotherapy (CCRT).Methods36 women with pathologically confirmed advanced cervical squamous carcinomas were enrolled in this prospective study. 3.0 T pelvic MR examinations including diffusion weighted imaging (b = 0, 800 s/mm2) were performed before CCRT (pre-CCRT) and at the end of 2nd week of CCRT (mid-CCRT). ADC histogram and texture features were derived from the whole volume of cervical cancers.ResultsWith a mean follow-up of 25 months (range, 11 ∼ 43), 10/36 (27.8%) patients ended with recurrence. Pre-CCRT 75th, 90th, correlation, autocorrelation and mid-CCRT ADCmean, 10th, 25th, 50th, 75th, 90th, autocorrelation can effectively differentiate the recurrence from nonrecurrence group with area under the curve ranging from 0.742 to 0.850 (P values range, 0.001 ∼ 0.038).ConclusionsPre- and mid-treatment whole-lesion ADC histogram and texture analysis hold great potential in predicting tumor recurrence of advanced cervical cancer treated with CCRT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

Meng

Zhu

et al. 2017

Oncotarget

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“…Several authors have compared pre-treatment ADC values in patients with versus without later tumour recurrence, finding that low pre-treatment ADC values seem to be a strong predictor of later tumour recurrence [ 22 , 101 – 107 ]. Furthermore, changes in ADC values during chemotherapy, radiotherapy or chemoradiation may help evaluate the treatment response [ 42 , 43 , 108 – 123 ]. For example, Kuang et al [ 42 ] examined 75 patients prior to, during and after therapy completion and found significantly higher ADCs in patients with complete response compared to those with partial response or stable disease after therapy completion.…”

Section: Tumour Recurrence and Therapeutic Responsementioning

confidence: 99%

The value of advanced MRI techniques in the assessment of cervical cancer: a review

et al. 2017

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ObjectivesTo assess the value of new magnetic resonance imaging (MRI) techniques in cervical cancer.MethodsWe searched PubMed and MEDLINE and reviewed articles published from 1990 to 2016 to identify studies that used MRI techniques, such as diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and dynamic contrast enhancement (DCE) MRI, to assess parametric invasion, to detect lymph node metastases, tumour subtype and grading, and to detect and predict tumour recurrence.ResultsSeventy-nine studies were included. The additional use of DWI improved the accuracy and sensitivity of the evaluation of parametrial extension. Most studies reported improved detection of nodal metastases. Functional MRI techniques have the potential to assess tumour subtypes and tumour grade differentiation, and they showed additional value in detecting and predicting treatment response. Limitations included a lack of technical standardisation, which limits reproducibility.ConclusionsNew advanced MRI techniques allow improved analysis of tumour biology and the tumour microenvironment. They can improve TNM staging and show promise for tumour classification and for assessing the risk of tumour recurrence. They may be helpful for developing optimised and personalised therapy for patients with cervical cancer.Teaching points • Conventional MRI plays a key role in the evaluation of cervical cancer. • DWI improves tumour delineation and detection of nodal metastases in cervical cancer. • Advanced MRI techniques show promise regarding histological grading and subtype differentiation. • Tumour ADC is a potential biomarker for response to treatment.

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“…Moreover, it may be possible to predict a possi-ble early recurrence based on DWI: A study from the year 2016 showed significant differences in ADC values between patients with tumor recurrence and patients without recurrence during radiochemotherapy treatment. A lower increase in ADC values during treatment was seen in patients with recurrence compared to patients without recurrence [37].…”

Section: Diagnosing Recurrencementioning

confidence: 77%

Revised FIGO Staging for Cervical Cancer – A New Role for MRI

Merz

Bossart

Bamberg

et al. 2020

Rofo

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Cervical cancer is still the fourth most common malignancy in women worldwide and has a high mortality rate. The prognosis as well as the therapy depends largely on the extent of the tumor at the time of initial diagnosis. This shows the importance of correct staging of cervical cancer. In order to promote a globally uniform approach, staging of cervical cancer in the past was based on widespread examinations such as exam under anesthesia, histology from cervical conization or biopsy, systematic lymphadenectomy, cystoscopy, proctoscopy, i. v.-pyelogram and chest X-ray. However, as the primary tumor stage was often underestimated, the 2018 revised FIGO classification now permits cross-sectional imaging techniques and pathological findings to be incorporated into disease staging or an already existing stage to be adapted based on radiological findings. Thanks to its excellent soft tissue contrast, magnetic resonance imaging (MRI) is the method of choice for local-regional staging of cervical cancer, evaluating the response to treatment, detecting tumor recurrence and for follow-up examinations. It is important that radiologists interpreting pelvic MRI in case of suspected cervical cancer are familiar with the current FIGO staging system. This is the only way to determine the tumor stage as precisely as possible and thus lay the foundation for the success of therapy for patients. The aim of this review is to present the changes of the revised FIGO classification as well as to show the importance of MRI as the method of choice for local-regional tumor staging as a complement to clinical examination. Key Points: Citation Format

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Can diffusion-weighted magnetic resonance imaging predict tumor recurrence of uterine cervical cancer after concurrent chemoradiotherapy?

Abstract: Tumor ADC changes between preTx and midTx might be a useful biomarker for the prediction of cervical cancer recurrence after CCRT.

Cited by 17 publications

References 25 publications

Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

The value of advanced MRI techniques in the assessment of cervical cancer: a review

Revised FIGO Staging for Cervical Cancer – A New Role for MRI

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