Magnetic Resonance Imaging in Gynecological Oncology

Harry, Vanessa N.; Deans, Heather; Ramage, Emma; Parkin, David E.; Gilbert, Fiona J.

doi:10.1111/igc.0b013e31819c52de

Cited by 21 publications

(13 citation statements)

References 103 publications

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“…In addition to conventional imaging, innovative techniques such as dynamic contrast-enhanced MRI and diffusion-weighted MRI show promise in offering early assessment of tumor response. 9 Concerning PET/PET-computed tomography (CT) in the management of gynecological malignancies, the promise of this technique is becoming increasingly evident. 2-Fluoro-2-deoxy-D-glucose-PET appears to have a potential role in assessing response to treatment and forecasting prognosis.…”

Section: Early Detection and Diagnosismentioning

confidence: 99%

“…10 and EPS8L2 in representative examples of endometrial carcinoma (upper panels). Specific staining at tumor glands (T) in contrast to faint labeling in normal glands (n) and stroma (st) in different histological types including endometrioid (1,3,4,5,6,7,8), serous (2) and clear cell (9) carcinomas. Western blot analysis of P4HB in paired samples including tumor tissue (T) and adjacent normal endometrium (N) from four different patients.…”

Section: Early Detection and Diagnosismentioning

confidence: 99%

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Molecular markers of endometrial carcinoma detected in uterine aspirates

Colás¹,

Pérez

Cabrera

et al. 2011

Intl Journal of Cancer

111

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Endometrial cancer (EC) is the most frequent of the invasive tumors of the female genital tract. Although usually detected in its initial stages, a 20% of the patients present with advanced disease. To date, no characterized molecular marker has been validated for the diagnosis of EC. In addition, new methods for prognosis and classification of EC are needed to combat this deadly disease. We thus aimed to identify new molecular markers of EC and to evaluate their validity on endometrial aspirates. Gene expression screening on 52 carcinoma samples and series of real‐time quantitative PCR validation on 19 paired carcinomas and normal tissue samples and on 50 carcinoma and noncarcinoma uterine aspirates were performed to identify and validate potential biomarkers of EC. Candidate markers were further confirmed at the protein level by immunohistochemistry and Western blot. We identified ACAA1, AP1M2, CGN, DDR1, EPS8L2, FASTKD1, GMIP, IKBKE, P2RX4, P4HB, PHKG2, PPFIBP2, PPP1R16A, RASSF7, RNF183, SIRT6, TJP3, EFEMP2, SOCS2 and DCN as differentially expressed in ECs. Furthermore, the differential expression of these biomarkers in primary endometrial tumors is correlated to their expression level in corresponding uterine fluid samples. Finally, these biomarkers significantly identified EC with area under the receiver‐operating‐characteristic values ranging from 0.74 to 0.95 in uterine aspirates. Interestingly, analogous values were found among initial stages. We present the discovery of molecular biomarkers of EC and describe their utility in uterine aspirates. These findings represent the basis for the development of a highly sensitive and specific minimally invasive method for screening ECs.

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Section: Early Detection and Diagnosismentioning

confidence: 99%

Section: Early Detection and Diagnosismentioning

confidence: 99%

Molecular markers of endometrial carcinoma detected in uterine aspirates

Colás¹,

Pérez

Cabrera

et al. 2011

Intl Journal of Cancer

111

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“…Magnetic resonance imaging (MRI) is an indispensable tool in cancer management, and is widely used for staging, treatment planning, and response monitoring (1). Functional MRI, such as dynamic contrast-enhanced (DCE)-MRI, provides biologic information related to tumor physiology (2).…”

Section: Introductionmentioning

confidence: 99%

“…There is a growing interest to use dynamic contrast enhanced MR imaging (DCE-MRI) to improve patient care by integrating anatomical and functional features (3). Locally advanced cervical cancer is one of the malignant diseases for which the inclusion of DCE-MRI could be helpful in clinical decision-making (1). Radiotherapy, often combined with cisplatin, is the primary treatment of choice and is challenging because of the risk of severe radiotoxicity in critical organs within the pelvis (4).…”

Section: Introductionmentioning

confidence: 99%

Hypoxia-Induced Gene Expression in Chemoradioresistant Cervical Cancer Revealed by Dynamic Contrast-Enhanced MRI

et al. 2012

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Knowledge of the molecular background of functional magnetic resonance (MR) images is required to fully exploit their potential in cancer management. We explored the prognostic impact of dynamic contrastenhanced MR imaging (DCE-MRI) parameters in cervical cancer combined with global gene expression data to reveal their underlying molecular phenotype and construct a representative gene signature for the relevant parameter. On the basis of 78 patients with cervical cancer subjected to curative chemoradiotherapy, we identified the prognostic DCE-MRI parameter A Brix by pharmacokinetic analysis of pretreatment images based on the Brix model, in which tumors with low A Brix appeared to be most aggressive. Gene set analysis of 46 tumors with pairwise DCE-MRI and gene expression data showed a significant correlation between A Brix and the hypoxia gene sets, whereas gene sets related to other tumor phenotypes were not significant. Hypoxia gene sets specific for cervical cancer created in cell culture experiments, including both targets of the hypoxia inducible factor (HIF1a) and the unfolded protein response, were the most significant. In the remaining 32 tumors, low A Brix was associated with upregulation of HIF1a protein expression, as assessed by immunohistochemistry, consistent with increased hypoxia. On the basis of the hypoxia gene sets, a signature of 31 genes that were upregulated in tumors with low A Brix was constructed. This DCE-MRI hypoxia gene signature showed prognostic impact in an independent validation cohort of 109 patients. Our findings reveal the molecular basis of an aggressive hypoxic phenotype and suggest the use of DCE-MRI to noninvasively identify patients with hypoxia-related chemoradioresistance. Cancer Res; 72(20); 5285-95. Ó2012 AACR.

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“…The examination evaluates the form of the tumor and its growth direction more precisely, thus improving the planning of radiation therapy. MRI examination methodology is also useful for assessing the efficiency of radiation or chemoradiation therapy and in the determination of tumor recurrence (6,8).…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging of cervical cancer

Atstupėnaitė¹,

Basevičius²,

Krimelis³

et al. 2011

AML

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Background. Diffusion-weighted magnetic resonance imaging (DW–MRI) has been employed in the diagnostics of malignant tumors of abdomen and pelvis relatively recently. Nowadays, there exists a particular interest in adaptation DW–MRI for assessing the response of tumors to chemoradiaton therapy. The aim of our study was to compare the mean value of the apparent diffusion coefficient (ADC) in a healthy cervix, cancer-affected cervix and a cervix after chemoradiation therapy, as well as to identify the ADC range typical of cervical cancer. Materials and methods. The study enrolled 108 female patients who underwent pelvic MRI in the Lithuanian University of Health Sciences Kaunas Clinics Hospital in 2008–2010. The study group consisted of 65 patients in whom cervical cancer had been clinically suspected and confirmed by biopsy before MRI examination. All these patients underwent pelvic MRI twice: before the chemoradiation therapy and 6 months after the therapy. The control group consisted of 43 patients in whom cervical cancer had been not suspected and MRI was performed because of other pelvic diseases. Results. The mean ADC value of the study group (0.658 ± 0.118 × 10–3 mm2/s) was lower than of the control group (1.171 ± 0.143 × 10–3 mm2/s) (t = 20.315, p = 0.03). The ADC threshold value of 0.945 × 10–3 mm2/s was defined, differentiating the cancer-affected cervical tissue from the normal. The mean ADC value of the patients who responded to chemoradiation therapy (1.111 ± 0.138 × 10–3 mm2/s) increased and in those who did not respond it remained lower (0.733 ± 0.073 × 10–3 mm2/s) (t = 9.518, p = 0.04). The ADC threshold value of 0.830 × 10–3 mm2/s was defined, differentiating the residual tumor tissue from the healthy cervical tissue after chemoradiation therapy. Conclusions. The ADC value in the case of cervical cancer was significantly lower than in the non-affected cervical tissue. The ADC value increases after effective chemoradiation therapy and becomes closer to the coefficient value of non-affected cervical tissue, but still remains lower. The 0.945 × 10–3 mm2/s ADC threshold was detected while differentiating between cancer-affected and normal cervical tissues, while the ADC threshold was 0.830 × 10–3 mm2/s when differentiating between residual tumor tissue and healthy cervical tissue after chemoradiation therapy at a high sensitivity and specificity. Keywords: diffusion-weighted magnetic resonance imaging, apparent diffusion coefficient, cervical cancer, chemoradiation therapy

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Magnetic Resonance Imaging in Gynecological Oncology

Cited by 21 publications

References 103 publications

Molecular markers of endometrial carcinoma detected in uterine aspirates

Molecular markers of endometrial carcinoma detected in uterine aspirates

Hypoxia-Induced Gene Expression in Chemoradioresistant Cervical Cancer Revealed by Dynamic Contrast-Enhanced MRI

Diffusion-weighted magnetic resonance imaging of cervical cancer

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