Blood oxygenation level-dependent MR imaging as a predictor of therapeutic response to concurrent chemoradiotherapy in cervical cancer: a preliminary experience.
OBJECTIVE
To investigate the value of blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) as a predictor of therapeutic response in cervical cancer patients undergoing concurrent chemoradiotherapy (CCRT).


METHODS
Thirty consecutive patients with biopsy-proven cervical cancer were examined by BOLD MRI before (preTx) and after CCRT (postTx). The R2* value (s(-1)) was calculated in the tumour and normal myometrium for preTx and postTx studies. Final tumour responses, as determined by changes of tumour size or volume on MRI, were correlated with tumour R2* values at preTx.


RESULTS
The mean R2* values of tumours at preTx (21.1) were significantly lower than those at postTx (39.4 s(-1)) (p < 0.001), while those of normal myometrium were similar between preTx and postTx (p = 0.363). At preTx, tumour R2* values showed significantly negative correlation with final tumour size response (p = 0.022, Spearman's coefficient = -0.415). However, tumour R2* values at preTx were not associated with final tumour volume response (p = 0.069).


CONCLUSIONS
BOLD MRI at 3 T, as an imaging biomarker, may have the potential to evaluate therapeutic response in cervical cancers. The association between BOLD MRI findings and CCRT responses warrants further validation.


CONCLUSIONS
• Hypoxia in cervical cancer is an independent risk factor • BOLD MRI reflect oxygenation status of tissue adjacent to perfused microvessels • Pretreatment tumour R2* reveal negative correlation with final tumour size response • Accurate oxygenation assessment in cervical cancer may help clinical decision making.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Republic of Korea.
Chan Kyo
CK
Kim
Sung Yoon
SY
Park
Byung Kwan
BK
Park
Won
W
Park
Seung Jae
SJ
Huh
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001706:Biopsy; D001918:Brachytherapy; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D020266:Radiotherapy, Conformal; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy
D000970:Antineoplastic Agents; D010100:Oxygen