Value of three‐dimensional power Doppler to predict clinical and histological response to neoadjuvant chemotherapy in locally advanced cervical carcinoma

Qin, Jiale; Cheng, Xiaodong; Chen, X.; Zhang, X.; Lü, Weiguo; Xie, Xing

doi:10.1002/uog.10071

Cited by 18 publications

(19 citation statements)

References 27 publications

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“…[12,13] It has been proven that vascularity of the invasive tumor assessed by transvaginal color Doppler ultrasound highly correlates with tumor size, parametrial invasion, lymph node metastasis, and response to neoadjuvant chemotherapy in histologically proven cervical carcinomas. [14,15] Assessing the velocimetric indices of UA and CA in the early period revealed some important changes in the present study. CA-RI was found to be significantly lower in patients with positive HPV and, in particular, with positive Hr-HPV.…”

Section: Discussionmentioning

confidence: 58%

Discriminating performance of early uterine and cervical artery pulsatility and resistivity in preinvasive cervical lesions

et al. 2018

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C ervical cancer is the second most common cancer in less developed regions; the average risk of death before age 75 years is three times lower in developed regions than in less developed regions, thus bringing a higher burden for developing countries. [1] An estimate of 12.820 new cervical cancer cases and 4210 deaths in the United States was reported in 2017. [2] Cervical cancer is the second leading cause of death due to cancer in women aged 20 to 39 years, accounting for 1 out of every 10 cancer deaths and emphasizing the need to improve screening rates in this age range. [2] Tens of thousands of invasive cervical cancer cases have been prevented owing to national organized screening programs for cervical cancer, and the beneficial impact of Objectives: The aim of the present study was to investigate the diagnostic effectiveness of uterine and cervical vascularity alone or in combination with human papillomavirus (HPV) DNA testing and with cytology. Methods: Data were prospectively collected from 129 patients in an outpatient clinic of a secondary setting. Routine liquid-based cervical cytology and HPV-DNA testing were obtained. An abnormal result of any of these high-risk types was viewed as positive. Pulsatility (PI) and resistance (RI) indices of uterine (UA) and cervical (CA) arteries were assessed by Doppler sonography. Pathological diagnosis was considered as the gold standard for assessment. Diagnostic efficiency of alone and joint screening of the three indices for discriminating cervical intraepithelial neoplasia (CIN-I) or above from below was assessed. Results: UA-RI and CA-RI were significantly lower in the HPV (+) group than in the controls (p=0.02 and p=0.03, respectively). In subsequent sub-analysis among patients with positive HPV-DNA, UA-PI was significantly higher in the HPV-16 (+) group than in the HPV-18 (+) group (p=0.04). High-risk HPV (Hr-HPV) testing had the highest sensitivity compared with Doppler and cytology (76.5%, 64.7%, and 58.5%, respectively). Combining CA-RI with cytology or Hr-HPV significantly reduced the sensitivity (23.5% and 29.4, respectively) but improved the specificity from 54.4% to 69.8% and 40.9% to 70.7%, respectively. Combining UA-PI with Hr-HPV slightly increased the positive predictivity when compared with testing Hr-HPV alone (36.1% vs. 33.3%). Conclusion: The potential of the Doppler indices of UA and CA was doubtful in discriminating CIN-I or above lesions in the early period. In addition, RI of UA and CA differed with regard to the presence of HPV infection, whereas CA-RI differed in high-risk HPV cases.

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Section: Discussionmentioning

confidence: 58%

Discriminating performance of early uterine and cervical artery pulsatility and resistivity in preinvasive cervical lesions

et al. 2018

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“…To the best of our knowledge, 3D ultrasound has not been compared with MRI with regard to identifying parametrial invasion of cervical cancer. However, in a pilot study including 14 patients, 3D ultrasound was found to be a promising tool for cervical cancer staging and 3D ultrasound has also been used to describe and detect cervical cancer and to predict clinical response to treatment.…”

Section: Discussionmentioning

confidence: 99%

Agreement of two‐dimensional and three‐dimensional transvaginal ultrasound with magnetic resonance imaging in assessment of parametrial infiltration in cervical cancer

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Valentini

et al. 2015

Ultrasound in Obstet & Gyne

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“…So, even if vascularization was not directly related to the response to CT, postoperative treatment (RT or CT-RT) was significantly more frequent in patients with “abundant” vascularization (OR: 20.8, 95% CI: 2–211). Moreover, Qin et al [26] demonstrated that VI, flow index, and vascularization flow index were significantly higher in clinical responders than in non-responders ( p < 0.05).…”

Section: Discussionmentioning

confidence: 99%

“…This result might be explained by the use of paclitaxel that has been shown to have an anti-angiogenic effect [26]. We may speculate that in non-responders the initial reduction of VI is overlapped by tumour load and chemoresistant cells.…”

Section: Discussionmentioning

confidence: 99%

The Role of 2D/3D Ultrasound to Assess the Response to Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer

et al. 2020

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Introduction: Different imaging techniques were introduced to improve preoperative clinical staging of locally advanced cervical cancer (LACC) with transvaginal ultrasound (TV-US) or transrectal ultrasound (TR-US) representing a promising staging technique in the evaluation of the local extension of the disease for invasive tumors. The aim of this study was to evaluate the response to neoadjuvant chemotherapy (NACT) in LACC by 2D/3D ultrasound examination. Materials and Methods: We prospectively enrolled patients affected by histologically and clinically confirmed LACC. All patients were scheduled for 3 cycles of platinum-based NACT followed by radical surgery. The ultrasound examination was performed at every cycle and within 10 days before surgery. The parameters evaluated were: the volume (automatically computed by the VOCAL software) and the mass vascularization. Results: From March 2010 to March 2019, 157 women were recruited. Among these patients, 12 of them were excluded: 6 for the presence of distant metastases, 4 for rare histology, and 2 for severe comorbidities not allowing the protocol treatment. Seventeen patients after NACT were excluded because they were not amenable to radical surgery. Thus, 128 were considered for the final analysis of whom 106 (83%) were considered responders to NACT by histology. The sensibility and specificity of ultrasound with regard to the response to chemotherapy compared to histological specimen were 94 and 82%, respectively, with an accuracy of 92%. The positive predictive value and negative predictive value were 96 and 75%, respectively. Finally, we found that nonetheless there was a trend towards a continuous response to chemotherapy among patients who were considered responders to NACT at pathological examination; the major volume and vascularization index (VI) reduction were observed during the first 2 cycles (74, 71% and 47, 63%, respectively). On the contrary, non-responders showed an initial reduction of the VI (4.86 consisting of 33%, 95% CI 0.79–8.92, p = 0.013), but no significant modification in tumour volume along NACT. Conclusion: 2D/3D ultrasound is useful in assessing early response to NACT in patients with LACC.

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Value of three‐dimensional power Doppler to predict clinical and histological response to neoadjuvant chemotherapy in locally advanced cervical carcinoma

Abstract: Objective Platinum-based neoadjuvant chemotherapy followed by radical hysterectomy is an alternative therapeutic strategy for locally advanced cervical carcinoma but variables used to predict chemotherapy response are not well defined. We investigated the potential of threedimensional (3D)

Cited by 18 publications

References 27 publications

Discriminating performance of early uterine and cervical artery pulsatility and resistivity in preinvasive cervical lesions

Discriminating performance of early uterine and cervical artery pulsatility and resistivity in preinvasive cervical lesions

Agreement of two‐dimensional and three‐dimensional transvaginal ultrasound with magnetic resonance imaging in assessment of parametrial infiltration in cervical cancer

The Role of 2D/3D Ultrasound to Assess the Response to Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer

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