TY - JOUR
T1 - The price study: The role of conventional and diffusion-weighted magnetic resonance imaging in assessment of locally advanced cervical cancer patients administered by chemoradiation followed by radical surgery
AU - Valentini, A. L.
AU - Micco', Maura
AU - Gui, B.
AU - Giuliani, M.
AU - Rodolfino, Elena
AU - Telesca, A. M.
AU - Pasciuto, Tina
AU - Testa, Antonia Carla
AU - Gambacorta, Maria Antonietta
AU - Zannoni, Gian Franco
AU - Rufini, Vittoria
AU - Giordano, Alessandro
AU - Valentini, Vincenzo
AU - Scambia, Giovanni
AU - Manfredi, Riccardo
PY - 2018
Y1 - 2018
N2 - Objectives To analyse the role of DW-MRI in early prediction of pathologically-assessed residual disease in locally-advanced cervical cancer (LACC) treated with neoadjuvant chemoradiotherapy followed by radical surgery. Methods Between October 2010–June 2014, 108 women with histologically-proven cervical cancer were screened; 88 were included in this study. Tumour volume (TV) and ADC mean were measured before (baseline-MRI) and after 2 weeks of chemoradiotherapy (early-MRI). According to histopathology, treatment response was classified as complete (CR) or partial (PR). Comparisons were made with Mann-Whitney, Wilcoxon and χ2 tests. ROC curves were generated for statistically significant parameters on univariate analysis. Results CR and PR were documented in 40 and 48 patients. At baseline-MRI, TV did not differ between groups. At early-MRI, TV was higher in PR than in CR (p=0.001). ΔTV reduction after treatment was lower in PR than in CR (63.6% vs. 81.1%; p=0.001). At baseline-MRI and early-MRI, ADC mean did not differ between PR and CR. ROC curve showed best cut-off for predicting pathological PR was ΔTV reduction of 73% with sensitivity, specificity, accuracy, NPV, PPV of 73%, 72.5%, 72.7%, 76%, 69%. Conclusions TV evaluated before and early after treatment could predict pathological response in LACC. ADC mean did not correlate with treatment outcome.
AB - Objectives To analyse the role of DW-MRI in early prediction of pathologically-assessed residual disease in locally-advanced cervical cancer (LACC) treated with neoadjuvant chemoradiotherapy followed by radical surgery. Methods Between October 2010–June 2014, 108 women with histologically-proven cervical cancer were screened; 88 were included in this study. Tumour volume (TV) and ADC mean were measured before (baseline-MRI) and after 2 weeks of chemoradiotherapy (early-MRI). According to histopathology, treatment response was classified as complete (CR) or partial (PR). Comparisons were made with Mann-Whitney, Wilcoxon and χ2 tests. ROC curves were generated for statistically significant parameters on univariate analysis. Results CR and PR were documented in 40 and 48 patients. At baseline-MRI, TV did not differ between groups. At early-MRI, TV was higher in PR than in CR (p=0.001). ΔTV reduction after treatment was lower in PR than in CR (63.6% vs. 81.1%; p=0.001). At baseline-MRI and early-MRI, ADC mean did not differ between PR and CR. ROC curve showed best cut-off for predicting pathological PR was ΔTV reduction of 73% with sensitivity, specificity, accuracy, NPV, PPV of 73%, 72.5%, 72.7%, 76%, 69%. Conclusions TV evaluated before and early after treatment could predict pathological response in LACC. ADC mean did not correlate with treatment outcome.
KW - Adult
KW - Aged
KW - Chemoradiotherapy
KW - Combined Modality Therapy
KW - Diffusion Magnetic Resonance Imaging
KW - Diffusionmagneticresonance imaging
KW - Female
KW - Humans
KW - Hysterectomy
KW - Magnetic Resonance Imaging
KW - Magnetic resonance imaging
KW - Middle Aged
KW - Neoadjuvant Therapy
KW - Neoplasm Staging
KW - Postoperative Care
KW - Prospective Studies
KW - ROC Curve
KW - Tumor Burden
KW - Tumour volume
KW - Uterine Cervical Neoplasms
KW - Uterine cervical neoplasms
KW - Adult
KW - Aged
KW - Chemoradiotherapy
KW - Combined Modality Therapy
KW - Diffusion Magnetic Resonance Imaging
KW - Diffusionmagneticresonance imaging
KW - Female
KW - Humans
KW - Hysterectomy
KW - Magnetic Resonance Imaging
KW - Magnetic resonance imaging
KW - Middle Aged
KW - Neoadjuvant Therapy
KW - Neoplasm Staging
KW - Postoperative Care
KW - Prospective Studies
KW - ROC Curve
KW - Tumor Burden
KW - Tumour volume
KW - Uterine Cervical Neoplasms
KW - Uterine cervical neoplasms
UR - http://hdl.handle.net/10807/149093
UR - http://www.link.springer.de/link/service/journals/00330/index.htm
U2 - 10.1007/s00330-017-5233-x
DO - 10.1007/s00330-017-5233-x
M3 - Article
SN - 0938-7994
VL - 28
SP - 2425
EP - 2435
JO - European Radiology
JF - European Radiology
ER -