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.
Eur Radiol
; 28(6): 2425-2435, 2018 Jun.
Article
en En
| MEDLINE
| ID: mdl-29318432
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 ADCmean 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, ADCmean 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. ADCmean did not correlate with treatment outcome. KEY POINTS ⢠Early-MRI tumour volume assessment could predict pathological response to nCRT in LACC. ⢠Best cut-off for predicting pathological PR was ΔTV reduction of 73 %. ⢠Early-MRI ADC mean measurements did not correlate with treatment outcome.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cuidados Posoperatorios
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Neoplasias del Cuello Uterino
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Imagen de Difusión por Resonancia Magnética
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Carga Tumoral
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Histerectomía
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Estadificación de Neoplasias
Tipo de estudio:
Health_economic_evaluation
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Observational_studies
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Prognostic_studies
Límite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Italia