title: Value of R2* obtained from T2*-weighted imaging in predicting the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy.
abstract: BACKGROUND
  To prospectively investigate the value of R2* in predicting the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy.
  
  
  METHODS
  Sixty-five patients with biopsy-proven cervical squamous carcinoma were enrolled in our study. All these subjects underwent multi-echo T2*-weighted MR imaging on a 3.0 Tesla MR scanner, and tumor R2* was calculated. The patients were divided into the responders and the nonresponders according to treatment effect. Tumor R2* values of these two groups were compared. The relationship between tumor R2* and prognosis after therapy was analyzed.
  
  
  RESULTS
  The responder group had lower R2* value than the nonresponder group (P = 0.02). The area under the receiver operating characteristics curve for tumor R2* in discriminating responders from nonresponders was 0.769. A cutoff value of 23.87 Hz for tumor R2* resulted in a sensitivity of 78.3% and a specificity of 67.6%. The low R2* group (≤28.37 Hz) had longer median progression-free survival period and overall survival period (P = 0.01, 0.03). Multivariate analysis showed that tumor R2* was a significant prognostic factor for progression-free survival and overall survival (adjusted hazards ratio = 5.34, 4.78; P = 0.02, 0.01).
  
  
  CONCLUSIONS
  R2* value obtained from T2*-weighted imaging, as an imaging biomarker, may be an important predictor for the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy.
authors.affiliation: Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China.
authors.forename: Xiang Sheng
authors.initials: XS
authors.lastname: Li
authors.affiliation: Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China.
authors.forename: Hong Xia
authors.initials: HX
authors.lastname: Fan
authors.affiliation: Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Fang
authors.affiliation: Department of MRI, Air Force General Hospital, People's Liberation Army, Beijing, China.
authors.forename: Yun Long
authors.initials: YL
authors.lastname: Song
authors.affiliation: Department of Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Chun Wu
authors.initials: CW
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D015588:Observer Variation; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: R2*; cervical carcinoma; concurrent chemoradiotherapy; magnetic resonance imaging; prognosis