Capillary permeability and extracellular volume fraction in uterine cervical cancer as patient outcome predictors: measurements by using dynamic MRI spin-lattice relaxometry.
OBJECTIVE
To improve the outcome prediction of uterine cervical carcinoma by measuring the vascular permeability (k(ep)) and the extracellular volume fraction (v(e)) of the tumor from Dynamic T(1)- IRM Relaxometry.


METHODS
Twenty-six patients with proven cervical carcinoma were divided into good outcome and poor outcome groups. Classic tumor prognostic factors, the longest diameter L and the volume V of the tumor, were measured from morphologic MR images. The tumor parameters k(ep) and v(e) were determined from the relaxometry time-curve acquired during the contrast uptake after a bolus intravenous injection of an extracellular contrast agent.


RESULTS
All "small" tumors (L<35 mm or V<11 cm(3)) were good outcome with 100% sensitivity but a rather low specificity (36% and 43% for L and V, respectively). With regard to the physiopathological parameter k(ep), "large" tumors (L >or= 35 mm) can also be classified as good outcome on the condition that k(ep) >or= 2.2 min(-1) with 100% sensitivity and 89% specificity. Regarding the extracellular volume fraction (v(e)), no significant difference was observed between the two groups.


CONCLUSIONS
Measurement of the tumor vascular permeability might be useful to predict prognostic, to evaluate the treatment efficacy, and to adapt a proper therapy schedule.
Dedieu
Véronique
V
Medical Physics, Department of Centre J. Perrin, Clermont-Ferrand, France. veronique.dedieu@cjp.fr
Bailly
Corinne
C
Vincent
Catherine
C
Achard
Jean-Louis
JL
Le Bouedec
Guillaume
G
Penault-Llorca
Frédérique
F
Verrelle
Pierre
P
Vincensini
Dominique
D
D000328:Adult; D000368:Aged; D002199:Capillary Permeability; D002277:Carcinoma / Q000098:blood supply* / Q000473:pathology / Q000628:therapy; D003287:Contrast Media; D018572:Disease-Free Survival; D005110:Extracellular Space; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000628:therapy
D003287:Contrast Media; D019786:Gadolinium DTPA