title: Short-term pretreatment DCE-MRI in prediction of outcome in locally advanced cervical cancer.
abstract: OBJECTIVE
  Several investigators have indicated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to provide biomarkers for personalized treatment of cervical carcinoma. However, some clinical studies have suggested that treatment failure is associated with low tumor signal enhancement, whereas others have reported associations between high signal enhancement and poor outcome. The purpose of this investigation was to clear up these conflicting reports and to provide a method for identifying biomarkers that easily can be implemented in routine DCE-MRI diagnostics.
  
  
  METHODS
  The study involved 85 patients (FIGO stage IB through IVA) treated with concurrent chemoradiotherapy. Low-enhancing tumor volume (LETV) and low-enhancing tumor fraction (LETF), defined as the volume and fractional volume of low-enhancing voxels, respectively, were calculated from signal intensities recorded within 1 min after contrast administration by using two methods reported to give conflicting conclusions.
  
  
  RESULTS
  Multivariate analysis involving tumor volume, lymph node status, FIGO stage, and LETV or LETF revealed that LETV and LETF provided independent prognostic information on treatment outcome, independent of the method of calculation.
  
  
  CONCLUSIONS
  Low signal enhancement is associated with poor prognosis in cervical carcinoma, and biomarkers predicting poor outcome can be provided by short-term DCE-MRI without advanced image analysis.
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Norway; Department of Radiology and Nuclear Medicine, Norway.
authors.forename: Kjersti V
authors.initials: KV
authors.lastname: Lund
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Norway.
authors.forename: Trude G
authors.initials: TG
authors.lastname: Simonsen
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Norway.
authors.forename: Tord
authors.initials: T
authors.lastname: Hompland
authors.affiliation: Department of Gynecological Cancer, Norway; Institute for Cancer Genetics and Informatics, Oslo University Hospital, Norway; Institute for Clinical Medicine, University of Oslo, Norway.
authors.forename: Gunnar B
authors.initials: GB
authors.lastname: Kristensen
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Norway. Electronic address: einar.k.rofstad@rr-research.no.
authors.forename: Einar K
authors.initials: EK
authors.lastname: Rofstad
mesh_terms: D059248:Chemoradiotherapy; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016896:Treatment Outcome; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D003287:Contrast Media
keywords: Cervical carcinoma; Concurrent chemoradiotherapy; DCE-MRI; Semiquantitative analysis; Treatment outcome