title: MR imaging-based evaluation of morphological changes in the uterus and ovaries of patients following neoadjuvant chemotherapy for cervical cancer.
abstract: OBJECTIVE
  We used magnetic resonance (MR) imaging and hormonal levels to evaluate the influence of chemotherapy for cervical cancer on female pelvic reproductive organs.
  
  
  METHODS
  We retrospectively evaluated 16 pre- and 11 postmenopausal patients with cervical cancer who underwent neoadjuvant chemotherapy (NACT) and radical surgery. We evaluated morphological changes in the uterus and ovaries by MR imaging both quantitatively and qualitatively, measuring the volume of the uterine body and bilateral ovaries, endometrial thickness, and signal intensity of the myometrium and bilateral ovaries and assessing visibility of the junctional zone and bilateral ovarian follicles. We compared both quantitative and qualitative factors between pre- and post-NACT. Pre- and post-NACT hormonal values of estradiol, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) of 8 patients in the premenopausal group were obtained and analyzed statistically.
  
  
  RESULTS
  In the premenopausal group, we observed a statistically significant decrease in all quantitative parameters as well as in the visibility of the left ovarian follicle. In the postmenopausal group, only endometrial thickness changed significantly. Premenopausal patients showed a statistically significant decrease in levels of progesterone, FSH, and LH after chemotherapy.
  
  
  CONCLUSIONS
  MR demonstrated changes in the uterus and ovaries in premenopausal subjects who underwent chemotherapy that resembled those changes classically reported in physiological postmenopausal subjects. These changes are likely due to ovarian toxicity and secondary hormonal changes. MR imaging might be a valuable tool for obtaining information regarding chemotherapy-induced infertility.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Himoto
authors.forename: Aki
authors.initials: A
authors.lastname: Kido
authors.forename: Koji
authors.initials: K
authors.lastname: Fujimoto
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: Tsukasa
authors.initials: T
authors.lastname: Baba
authors.forename: Noriomi
authors.initials: N
authors.lastname: Matsumura
authors.forename: Ikuo
authors.initials: I
authors.lastname: Konishi
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010053:Ovary / Q000187:drug effects* / Q000473:pathology*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D014599:Uterus / Q000187:drug effects* / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone