Pretreatment late-phase DCE-MRI predicts outcome in locally advanced cervix cancer

Acta Oncol. 2017 May;56(5):675-681. doi: 10.1080/0284186X.2017.1294762. Epub 2017 Feb 28.

Abstract

Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may provide prognostic biomarkers for cervix carcinoma. We have shown previously that the early phase of the signal intensity-versus-time curve (SITC) may have significant prognostic power. The purpose of the present investigation was to explore the prognostic value of the late phase of the SITC.

Material and methods: DCE-MRI data of 80 patients (FIGO stage IB-IVA) treated with concurrent chemoradiotherapy were examined. Four parameters were calculated from the late-phase SITC: tumor volume with decreasing signal, tumor fraction with decreasing signal, tumor volume with increasing signal (TVIS), and tumor fraction with increasing signal.

Results: Multivariate analysis involving clinical parameters and late-phase SITC parameters suggested that TVIS is a strong independent prognostic factor for both disease-free and overall survival. When early-phase SITC parameters were included in the multivariate analysis, the early-phase SITC, but not the late-phase SITC, was found to have independent prognostic value.

Conclusion: The late-phase SITC can provide prognostic factors for the outcome of cervix carcinoma, that is, a large tumor volume with increasing late-phase SITCs is associated with poor outcome. However, the prognostic power of the late-phase SITC is not as strong as that of the early-phase SITC.

MeSH terms

  • Chemoradiotherapy / mortality*
  • Contrast Media / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / metabolism
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Survival Rate
  • Tumor Burden
  • Uterine Cervical Neoplasms / diagnostic imaging
  • Uterine Cervical Neoplasms / metabolism
  • Uterine Cervical Neoplasms / mortality*
  • Uterine Cervical Neoplasms / pathology

Substances

  • Contrast Media