Early treatment response of patients undergoing concurrent chemoradiotherapy for cervical cancer: An evaluation of integrated multi-parameter PET-IVIM MR. Issue 117 (August 2019)

• Record Type: Journal Article
• Authors: Xu, Chen; Sun, Hongzan; Du, Siyao; Xin, Jun
• Is Part Of: European journal of radiology. Issue 117(2019)
• Page Start: 1
• Page End: 8
• Publication Date: 2019-08
• Subjects: Cervical cancer -- Integrated PET-MR -- Concurrent chemoradiotherapy -- Treatment response; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.05.012
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To evaluate the value of integrated multi-parameter positron emission tomography-intravoxel incoherent motion magnetic resonance (PET-IVIM MR) imaging in the assessment of treatment response in patients with cervical cancer treated with concurrent chemoradiotherapy (CCRT). Materials and methods: A total of 41 patients underwent PET-MR scans before, during (at the end of the third week) and after CCRT were included in this study. The PET-MR imaging parameters were measured on the tumor and the percentage change between the two time points were calculated before and during the treatment. These parameters were used to evaluate treatment response. A combination prediction model was constructed using multivariate logistic regression. European Organization for Research and Treatment of Cancer (EORTC)criteria, measured by the post-therapy(PostTx) PET/MR were used to classify treatment responses: patients were classified into the complete metabolic responder (CMR) group or the non-complete metabolic responders (N-CMR) group. The correlations between PET and IVIM parameters and percentage changes during CCRT were investigated using the Spearman rank correlation. Results: In all, 13 of 41 (31.7%) patients were defined as N-CMR group. According to constructing multivariate logistic regression, the combination of pre-therapy(Pre-Tx) total metabolic tumor volume(MTV), the percentage changes of the maximum standardized uptake value (ΔSUVmax ) and the mean diffusion-related coefficient (ΔDmean ) during CCRT had the strongest predictive potentiality(AUC 0.912, P < 0.05).In addition, during CCRT the percentage changes in minimum diffusion-related coefficient(ΔDmin ) was correlated with ΔSUVmax (Spearman correlation coefficient, r＝0.338, P < 0.05). Conclusions: The combination of Pre-Tx MTV, ΔSUVmax and ΔDmean had the strongest predictive value in evaluating treatment response for patients with cervical cancer treated with CCRT. Other imaging parameters can be replaced by these 3 parameters because of their similarities and lower predictive values. In addition, ΔDmin and ΔSUVmax have a similar value for evaluating treatment response after CCRT in cervical cancer.