• Int. J. Radiat. Oncol. Biol. Phys. · Mar 2012

    Dynamic contrast-enhanced MRI of cervical cancers: temporal percentile screening of contrast enhancement identifies parameters for prediction of chemoradioresistance.

    • Erlend K F Andersen, Knut Håkon Hole, Kjersti V Lund, Kolbein Sundfør, Gunnar B Kristensen, Heidi Lyng, and Eirik Malinen.
    • Department of Medical Physics, Oslo University Hospital, Oslo, Norway.
    • Int. J. Radiat. Oncol. Biol. Phys. 2012 Mar 1; 82 (3): e485-92.

    PurposeTo systematically screen the tumor contrast enhancement of locally advanced cervical cancers to assess the prognostic value of two descriptive parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Methods And MaterialsThis study included a prospectively collected cohort of 81 patients who underwent DCE-MRI with gadopentetate dimeglumine before chemoradiotherapy. The following descriptive DCE-MRI parameters were extracted voxel by voxel and presented as histograms for each time point in the dynamic series: normalized relative signal increase (nRSI) and normalized area under the curve (nAUC). The first to 100th percentiles of the histograms were included in a log-rank survival test, resulting in p value and relative risk maps of all percentile-time intervals for each DCE-MRI parameter. The maps were used to evaluate the robustness of the individual percentile-time pairs and to construct prognostic parameters. Clinical endpoints were locoregional control and progression-free survival. The study was approved by the institutional ethics committee.ResultsThe p value maps of nRSI and nAUC showed a large continuous region of percentile-time pairs that were significantly associated with locoregional control (p < 0.05). These parameters had prognostic impact independent of tumor stage, volume, and lymph node status on multivariate analysis. Only a small percentile-time interval of nRSI was associated with progression-free survival.ConclusionsThe percentile-time screening identified DCE-MRI parameters that predict long-term locoregional control after chemoradiotherapy of cervical cancer.Copyright © 2012 Elsevier Inc. All rights reserved.

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