Value of integrated PET-IVIM MR in assessing metastases in hypermetabolic pelvic lymph nodes in cervical cancer: a multi-parameter study

Xu, Chen; Du, Siyao; Zhang, Siyu; Wang, Bo; Dong, Chengyan; Sun, Hongzan

doi:10.1007/s00330-019-06611-z

Cited by 16 publications

(8 citation statements)

References 31 publications

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“…43 GLUT1 and MCT4 may indicate the accumulation of lactic acid, and the accumulation of lactic acid in malignant tumors indicates the formation of metastasis. 44,45 This interpretation may also explain why the SUVmax of SCC is higher than that of AC.…”

Section: Discussionmentioning

confidence: 97%

“…In particular, AC may mainly rely on aerobic glycolysis to produce ATP, while SCC relies on mitochondrial oxidation and anaerobic glycolysis under hypoxic conditions 43 . GLUT1 and MCT4 may indicate the accumulation of lactic acid, and the accumulation of lactic acid in malignant tumors indicates the formation of metastasis 44,45 . This interpretation may also explain why the SUVmax of SCC is higher than that of AC.…”

Section: Discussionmentioning

confidence: 99%

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A Comparative Study of Amide Proton Transfer Weighted Imaging and Intravoxel Incoherent Motion MRI Techniques Versus (18) F‐FDG PET to Distinguish Solitary Pulmonary Lesions and Their Subtypes

Fang

Meng

Feng

et al. 2021

Magnetic Resonance Imaging

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Background Amide proton transfer weighted imaging (APTw), intravoxel incoherent motion (IVIM), and positron emission tomography (PET) imaging all have the potential to characterize solitary pulmonary lesions (SPLs). Purpose To compare APTw and IVIM with PET imaging for distinguishing between benign and malignant SPLs and their subtypes. Study Type Prospective. Population Ninety‐five patients, 78 with malignant SPLs (including 48 with adenocarcinoma [AC] and 17 with squamous cell carcinoma [SCC]), and 17 with benign SPLs. Field Strength/Sequence Fast spin‐echo (FSE) T2WI, FSE APTw and echo‐planar imaging IVIM, MR‐base attenuation correction (MRAC), and PET imaging on a 3‐T whole‐body PET/MR system. Assessment The magnetization transfer ratio asymmetry (MTRasym) at 3.5 ppm, diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), and the maximum standardized uptake value (SUVmax) were analyzed. Statistical Tests Individual sample t‐test, Delong test, Pearson's correlation analysis, and area under the receiver operating characteristic curve (AUC). P < 0.05 indicated statistical significance. Results The MTRasym and SUVmax were significantly higher, and D was significantly lower in the malignant group (3.3 ± 2.6 [%], 7.8 ± 5, and 1.2 ± 0.3 [×10−3 mm2/second]) compared to the benign group (−0.3 ± 1.6 [%], 3.1 ± 3.8, and 1.6 ± 0.3 [×10−3 mm2/second]). The MTRasym and D were significantly lower, and SUVmax was significantly higher in the SCC group (0.8 ± 1.0 [%], 1.0 ± 0.2 [×10−3 mm2/second] than in the AC group (4.1 ± 2.6 [%], 1.3 ± 0.3 [×10−3 mm2/second], 6.7 ± 4.6). Besides, the combination (AUC = 0.964) of these three methods showed higher diagnostic efficacy than any individual method (AUC = 0.917, 0.851, 0.82, respectively) in identifying malignant and benign SPLs. However, APTw showed better diagnostic efficacy than the combination of three methods or PET imaging alone in distinguishing SCC and AC groups (AUC = 0.934, 0.781, 0.725, respectively). Data Conclusion APTw, IVIM, and PET imaging are all effective methods to distinguish benign and malignant SPLs and their subtypes. APTw is potentially more capable than PET imaging of distinguishing lung SCC from AC. Level of Evidence 2 Technical Efficacy Stage 2

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Amide Proton Transfer Weighted Imaging and Intravoxel Incoherent Motion MRI Techniques Versus (18) F‐FDG PET to Distinguish Solitary Pulmonary Lesions and Their Subtypes

Fang

Meng

Feng

et al. 2021

Magnetic Resonance Imaging

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“…The resection of lymph nodes involved the obturator lymph nodes and the internal, common, and external iliac vessel lymph nodes. Para-aortic nodes should be removed only in the following cases: (1) The preoperative PET/CT showed that there were suspicious metastatic lymph nodes in the para-aortic area [SUVmax of lymph nodes is higher than the background metabolism level ( 23 , 24 )]; and (2) the possibility of metastasis in the pelvic or para-aortic lymph nodes was suspected intra-operatively.…”

Section: Methodsmentioning

confidence: 99%

Markers of Prognosis for Early Stage Cervical Cancer Patients (Stage IB1, IB2) Undergoing Surgical Treatment

Sun

et al. 2021

Front. Oncol.

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BackgroundFor individuals with cervical cancer, large tumor volume, lymph node metastasis, distant metastasis, and parauterine infiltration are usually associated with a poor prognosis. Individuals with stage 1B1 and 1B2 cervical cancer usually do not have these unfavorable prognostic factors. Once the disease progresses, the prognosis becomes extremely poor. Therefore, investigating the prognostic markers of these cervical cancer patients is necessary for treatment.MethodsThis retrospective study included 95 cervical cancer patients treated with surgery. The patients were divided into progressor and non-progressor groups according to postoperative follow-up results. T-test (or Mann−Whitney U test), chi-squared test (or Fisher’s exact test) and receiver operating characteristic (ROC) curves were used to evaluate imaging, hematology, and clinicopathological index differences between the two groups. Cox analysis was performed to select the independent markers of progression-free survival (PFS) when developing the nomogram. Validation of the nomogram was performed with 1000 bootstrapped samples. The performance of the nomogram was validated with ROC curves, generated calibration curves, and Kaplan-Meier and decision curve analysis (DCA).ResultsCervical stromal invasion depth, lymphovascular space invasion (LVSI), human papilloma virus (HPV-16), Glut1, D-dimer, SUVmax and SUVpeak showed significant differences between the two groups. Multivariate Cox proportional hazard model showed SUVpeak (p = 0.012), and HPV-16 (p = 0.007) were independent risk factors and were used to develop the nomogram for predicting PFS. The ROC curves, Kaplan-Meier method, calibration curves and DCA indicated satisfactory accuracy, agreement, and clinical usefulness, respectively.ConclusionsSUVpeak level (≥7.63 g/cm3) and HPV-16 negative status before surgery were associated with worse PFS for patients with cervical cancer. Based on this result, we constructed the nomogram and showed satisfactory performance. Clinically, individualized clinical decision-making can be performed on patients based on this result.

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“…IVIM allows to distinguishes the diffusion of water molecules in the extracellular space from capillary microperfusion through three quantitative parameters: diffusion "D" (diffusion of water in extracellular space); pseudo-diffusion "D*" (the movement of blood water molecules in the capillary network) and perfusion fraction "fp" (volume percentage of water flowing in the capillaries) (44). Different authors have highlighted correlations between this IVIM parameters and CC regarding: the detection of cervical cancer tissue, the presence of lymph node metastasis and treatment response (45)(46)(47)(48)(49)(50)(51)(52)(53). Moreover, recent studies suggested that a IVIM model may also predict the tumor aggressiveness and therapy response showing that D values were significantly higher in good responders patients (p = 0.001) and in moderate/high TILs (p = 0.018) and that fp showed significantly higher values in squamous cell tumors (p = 0.006) (54).…”

Section: Intravoxel Incoherent Motionmentioning

confidence: 99%

Post treatment imaging in patients with local advanced cervical carcinoma

Ciulla

Celli²,

Aiello³

et al. 2022

Front. Oncol.

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Cervical cancer (CC) is the fourth leading cause of death in women worldwide and despite the introduction of screening programs about 30% of patients presents advanced disease at diagnosis and 30-50% of them relapse in the first 5-years after treatment. According to FIGO staging system 2018, stage IB3-IVA are classified as locally advanced cervical cancer (LACC); its correct therapeutic choice remains still controversial and includes neoadjuvant chemo-radiotherapy, external beam radiotherapy, brachytherapy, hysterectomy or a combination of these modalities. In this review we focus on the most appropriated therapeutic options for LACC and imaging protocols used for its correct follow-up. We explore the imaging findings after radiotherapy and surgery and discuss the role of imaging in evaluating the response rate to treatment, selecting patients for salvage surgery and evaluating recurrence of disease. We also introduce and evaluate the advances of the emerging imaging techniques mainly represented by spectroscopy, PET-MRI, and radiomics which have improved diagnostic accuracy and are approaching to future direction.

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Value of integrated PET-IVIM MR in assessing metastases in hypermetabolic pelvic lymph nodes in cervical cancer: a multi-parameter study

Cited by 16 publications

References 31 publications

A Comparative Study of Amide Proton Transfer Weighted Imaging and Intravoxel Incoherent Motion MRI Techniques Versus (18) F‐FDG PET to Distinguish Solitary Pulmonary Lesions and Their Subtypes

A Comparative Study of Amide Proton Transfer Weighted Imaging and Intravoxel Incoherent Motion MRI Techniques Versus (18) F‐FDG PET to Distinguish Solitary Pulmonary Lesions and Their Subtypes

Markers of Prognosis for Early Stage Cervical Cancer Patients (Stage IB1, IB2) Undergoing Surgical Treatment

Post treatment imaging in patients with local advanced cervical carcinoma

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