title: Assessment of the early predictive power of quantitative magnetic resonance imaging parameters during neoadjuvant chemotherapy for uterine cervical cancer.
abstract: OBJECTIVE
  The purpose of this study was to quantitatively evaluate 3 types of magnetic resonance imaging (MRI) parameters in parallel for the early prediction of neoadjuvant chemotherapy (NACT) effectiveness in cervical cancer-tumor volume parameters, diffusion parameters, and perfusion parameters.
  
  
  METHODS
  We prospectively evaluated 13 patients with International Federation of Gynecology and Obstetrics stage IB to IIB cervical squamous cell carcinoma who underwent 3 serial MRI studies, that is, pretreatment, post-first course NACT, and post-second course NACT followed by radical hysterectomy. We obtained tumor volume parameters, diffusion parameters, and dynamic contrast material-enhanced perfusion parameters quantitatively from pretreatment MRI and post-first course MRI. The correlation of these parameters and the eventual tumor volume regression rate (TVRR) obtained from pretreatment MRI and post-second course MRI before surgery were investigated, statistically based on the Pearson correlation coefficient.
  
  
  RESULTS
  Thirteen patients had a total of 39 scans. Early TVRR (r = 0.844; P < 0.001), the fractional volume of the tissue extracellular extravascular space (Ve, r = 0.648; P < 0.05), and the change of Ve during the first course of NACT (r = -0.638; P < 0.05) correlated with eventual TVRR.
  
  
  CONCLUSIONS
  Early TVRR, Ve, and the change of Ve could be useful predictors for the treatment effectiveness of NACT. These parameters could help to modify strategy in the early stage of NACT and to choose individualized treatment to avoid the delay of radical treatment, even when NACT is ineffective.
authors.affiliation: Departments of *Diagnostic Imaging and Nuclear Medicine, and †Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Himoto
authors.forename: Koji
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Aki
authors.initials: A
authors.lastname: Kido
authors.forename: Noriomi
authors.initials: N
authors.lastname: Matsumura
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Baba
authors.forename: Sayaka
authors.initials: S
authors.lastname: Daido
authors.forename: Kayo
authors.initials: K
authors.lastname: Kiguchi
authors.forename: Fuki
authors.initials: F
authors.lastname: Shitano
authors.forename: Ikuo
authors.initials: I
authors.lastname: Konishi
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011446:Prospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology*