ADC and kinetic parameter of primary tumor: Surrogate imaging markers for fertility-sparing vaginal radical trachelectomy in patients with stage IB cervical cancer. Issue 155 (October 2022)

• Record Type: Journal Article
• Authors: Bai, Zhiqiang; Shi, Jie; Wang, Jue; Zhong, Jinglian; Zeng, Weike; Yang, Zehong; Hu, Huijun; Shen, Jun
• Is Part Of: European journal of radiology. Issue 155(2022)
• Publication Date: 2022-10
• Subjects: Fertility preservation -- Multiparametric magnetic resonance imaging -- Trachelectomy -- Uterine cervical neoplasms; VRT vaginal radical trachelectomy -- ROI region of interest -- Ktrans volume transfer constant -- Kep efflux rate constant -- Ve volume fraction of extravascular extracellular space -- Vp volume fraction of plasma -- TTP time to peak -- MaxCon maximum concentration -- MaxSlope maximum slope -- AUC area under time-signal intensity curve -- ROC receiver operating characteristic -- AUROC area under ROC curve -- PPV positive predictive value -- NPV negative predictive value -- ICC intra-class correlation coefficient; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110467
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: ADC abd DCE-MRI kinetic parameters including Vp and TTP of the primary tumor differ between eligible and ineligible candidates for fertility-sparing VRT. ADC and Vp are independent predictors for VRT eligibility. Combining ADC and Vp achieves a high performance in predicting VRT eligibility. Abstract: Purpose: To investigate the role of ADC and kinetic parameters derived from DCE-MRI in selecting eligible candidates for fertility-sparing vaginal radical trachelectomy (VRT). Method : Female patients with FIGO stage IB cervical cancers between March 2019 and January 2022 were retrospectively included. All patients underwent hysterectomy and bilateral lymphadenectomy. According to the surgical pathology, the study population was divided into VRT-eligible group and VRT-ineligible group. ADC, semi-quantitative and quantitative kinetic parameters of the primary tumor were compared between the two groups. Logistic regression analysis was used to determine the independent predictors for VRT eligibility and ROC curve was used to evaluate the predictive performance. Results : 19 patients were deemed eligible for VRT and 50 were ineligible. Compared with VRT-eligible group, time to peak and ADC were significantly lower in VRT-ineligible group ( P = 0.004 and 0.001, respectively) while volume fraction of plasma (Vp ) was higher in VRT ineligible group ( P = 0.001). ADC and Vp were independent predictors for VRT eligibility. Combining Vp and ADC yielded the highest area under the ROC curve of 0.853 compared with that of 0.766 for Vp and 0.764 for ADC, though marginal differences were found ( P = 0.109 and 0.078, respectively). Conclusions : ADC and the kinetic DCE-MRI parameter Vp can be used as surrogate markers to select eligible candidates for fertility-sparing VRT.