Functional Magnetic Resonance Imaging in Cervical Cancer Diagnosis and Treatment

Abdul-Latif, Mohammed; Tsang, Y.; Hoskin, Peter

doi:10.1016/j.clon.2023.05.006

Cited by 2 publications

(2 citation statements)

References 72 publications

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“…Refinement of fMRI as a predictive and prognostic marker can be improved further by combining clinicopathological scoring and or genomic signatures for hypoxia. 6 In addition to a multiparametric approach, fMRI needs to be repeated across treatment to discern tumour response and relate it to fMRI-derived parameters. Spatial data can also be acquired-an example of which DCE-MRI can identify a 'functional risk volume' within the tumour associated with poorer response to treatment.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

E xploratory study of using M agnetic resonance P rognostic I maging markers for R adiotherapy I n C ervix cancer (EMPIRIC): a prospective cohort study protocol

Abdul-Latif,

Chowdhury,

Tharmalingam

et al. 2024

BMJ Open

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IntroductionRadical chemoradiotherapy represents the gold standard for locally advanced cervical cancer. However, despite significant progress in improving local tumour control, distant relapse continues to impact overall survival. The development of predictive and prognostic biomarkers is consequently important to risk-stratify patients and identify populations at higher risk of poorer treatment response and survival outcomes. Exploratory study of using Magnetic resonance Prognostic Imaging markers for Radiotherapy In Cervix cancer (EMPIRIC) is a prospective exploratory cohort study, which aims to investigate the role of multiparametric functional MRI (fMRI) using diffusion-weighed imaging (DWI), dynamic contrast-enhanced (DCE) and blood oxygen level-dependent imaging (BOLD) MRI to assess treatment response and predict outcomes in patients undergoing radical chemoradiotherapy for cervical cancer.Methods and analysisThe study aims to recruit 40 patients across a single-centre over 2 years. Patients undergo multiparametric fMRI (DWI, DCE and BOLD-MRI) at three time points: before, during and at the completion of external beam radiotherapy. Tissue and liquid biopsies are collected at diagnosis and post-treatment to identify potential biomarker correlates against fMRI. The primary outcome is to evaluate sensitivity and specificity of quantitative parameters derived from fMRI as predictors of progression-free survival at 2 years following radical chemoradiotherapy for cervical cancer. The secondary outcome is to investigate the roles of fMRI as predictors of overall survival at 2 years and tumour volume reduction across treatment. Statistical analyses using regression models and survival analyses are employed to evaluate the relationships between the derived parameters, treatment response and clinical outcomes.Ethics and disseminationThe EMPIRIC study received ethical approval from the NHS Health Research Authority (HRA) on 14 February 2022 (protocol number RD2021-29). Confidentiality and data protection measures are strictly adhered to throughout the study. The findings of this study will be disseminated through peer-reviewed publications and scientific conferences, aiming to contribute to the growing body of evidence on the use of multiparametric MRI in cervical cancer management.Trial registration numberNCT05532930.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

E xploratory study of using M agnetic resonance P rognostic I maging markers for R adiotherapy I n C ervix cancer (EMPIRIC): a prospective cohort study protocol

Abdul-Latif,

Chowdhury,

Tharmalingam

et al. 2024

BMJ Open

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“…Additionally, it helps ascertain whether lesions are confined to the cervix, parametrium, or pelvic wall. Pelvic MRI provides an important foundation for pretreatment characterization and staging in patients with early-stage cervical cancer ( 5 , 6 ). However, when using the conventional external array coil (this is referred to as the conventional coil ), the clinical findings of early-stage cervical cancer are inadequately visualized in the MRI images, and the image resolution truly cannot meet diagnostic requirements, particularly for tumors below stage IB1 and smaller than 2 cm ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Endovaginal coil for pelvic high-resolution magnetic resonance imaging of cervical cancer: a preliminary parameter optimization study

Zhang,

Yu,

Tang

et al. 2024

Quant Imaging Med Surg

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Background The diagnosis of early-stage cervical cancer through conventional magnetic resonance imaging (MRI) remains challenging, highlighting a greater need for pelvic high-resolution MRI (HR MRI). This study used our research team’s endovaginal coil imaging to optimize scanning parameters and aimed to achieve HR MRI of the pelvis and determine its clinical value. Methods Fifty participants were recruited prospectively for this cross-sectional study conducted at the First Affiliated Hospital of Chongqing Medical University from January 2023 to November 2023. Initially, 10 volunteers requiring pelvic imaging diagnosis underwent pelvic MRI with the endovaginal coil combined with a conventional external array coil to test and optimize the scanning parameters. Subsequently, 40 patients who were highly suspected or diagnosed with cervical cancer were randomly assigned to undergo an initial pelvic scan with an external array coil with subsequent examinations of both the conventional coil and the endovaginal coil. Two experienced radiologists performed quantitative analyses, measuring signals and calculating the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast (C). They also conducted qualitative analyses, evaluating imaging artifacts, anatomical structures, and overall image quality. The paired sample t -test and Wilcoxon rank-sum test were conducted to compare the statistical differences between the two sets of images, while the intraclass correlation coefficient (ICC) and Kappa consistency tests were used to assess the measurement and scoring consistency between the two radiologists. Results The optimized endovaginal images had higher mean SNR, CNR, and C values (18.62±7.85, 16.04±7.72, and 0.73±0.11, respectively) compared to the conventional images (6.77±2.36, 4.47±2.05, and 0.47±0.12, respectively). Additionally, the ratings for imaging artifacts, anatomical structures, and overall quality of the endovaginal images were all 4 [interquartile range (IQR) 4, 4]; meanwhile, the conventional images scored lower with ratings of 4 (IQR 3, 4), 3 (IQR 3, 3), and 3 (IQR 3, 3) for SNR, CNR, and C, respectively. All analysis results underwent paired-sample t -tests or Wilcoxon rank-sum tests between the two groups, yielding a P value <0.001. The optimized endovaginal images also showed improved resolution with a reconstructed voxel size of 0.11 mm 3 , and HR MRI was successfully achieved. The ICC values for the measurements were 0.914, 0.947, and 0.912, respectively, and for the ratings, the measurement was 0.923, indicating excellent consistency between the two physicians (ICC/Kappa value between 0.85 and 1.00). Conclusions Endovaginal technology, which provides precise clinical information for the diagnosis of cervical cancer, provides straightforward operation and exceptional imaging quality, making it highly suita...

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Functional Magnetic Resonance Imaging in Cervical Cancer Diagnosis and Treatment

Cited by 2 publications

References 72 publications

E xploratory study of using M agnetic resonance P rognostic I maging markers for R adiotherapy I n C ervix cancer (EMPIRIC): a prospective cohort study protocol

E xploratory study of using M agnetic resonance P rognostic I maging markers for R adiotherapy I n C ervix cancer (EMPIRIC): a prospective cohort study protocol

Endovaginal coil for pelvic high-resolution magnetic resonance imaging of cervical cancer: a preliminary parameter optimization study

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