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

A. L. Valentini, Maura Micco', B. Gui, M. Giuliani, Elena Rodolfino, A. M. Telesca, Tina Pasciuto, Antonia Carla Testa, Maria Antonietta Gambacorta, Gian Franco Zannoni, Vittoria Rufini, Alessandro Giordano, Vincenzo Valentini, Giovanni Scambia, Riccardo Manfredi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

10 Citazioni (Scopus)

Abstract

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.
Lingua originaleEnglish
pagine (da-a)2425-2435
Numero di pagine11
RivistaEuropean Radiology
Volume28
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Adult
  • Aged
  • Chemoradiotherapy
  • Combined Modality Therapy
  • Diffusion Magnetic Resonance Imaging
  • Diffusionmagneticresonance imaging
  • Female
  • Humans
  • Hysterectomy
  • Magnetic Resonance Imaging
  • Magnetic resonance imaging
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Postoperative Care
  • Prospective Studies
  • ROC Curve
  • Tumor Burden
  • Tumour volume
  • Uterine Cervical Neoplasms
  • Uterine cervical neoplasms

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