title: 1H MR spectroscopy in cervical carcinoma using external phase array body coil at 3.0 Tesla: Prediction of poor prognostic human papillomavirus genotypes.
abstract: To assess the clinical value of proton (1H) MR spectroscopy in cervical carcinomas, in the prediction of poor prognostic human papillomavirus (HPV) genotypes as well as persistent disease following concurrent chemoradiotherapy (CCRT).
  
  
  
  1H MR spectroscopy using external phase array coil was performed in 52 consecutive cervical cancer patients at 3 Tesla (T). Poor prognostic HPV genotypes (alpha-7 species or absence of HPV infection) and persistent cervical carcinoma after CCRT were recorded. Statistical significance was calculated with the Mann-Whitney two-sided nonparametric test and areas under the receiver operating characteristics curve (AUC) analysis.
  
  
  
  A 4.3-fold (P = 0.032) increased level of methyl resonance at 0.9 ppm was found in the poor prognostic HPV genotypes, mainly attributed to the presence of HPV18, with a sensitivity of 75%, a specificity of 81%, and an AUC of 0.76. Poor prognostic HPV genotypes were more frequently observed in patients with adeno-/adenosquamous carcinoma (Chi-square, P < 0.0001). In prediction of the four patients with persistent disease after CCRT, elevated methyl resonance demonstrated a sensitivity of 100%, a specificity of 74%, and an AUC of 0.82.
  
  
  
  1H MR spectroscopy at 3T can be used to depict the elevated lipid resonance levels in cervical carcinomas, as well as help to predict the poor prognostic HPV genotypes and persistent disease following CCRT. Further large studies with longer follow up times are warranted to validate our initial findings.
  
  
  
  1 J. Magn. Reson. Imaging 2017;45:899-907.
authors.affiliation: Department of Medical Imaging and Intervention, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.|Clinical Phenome Center, Chang Gung Memorial Hospital at Linkou, Guishan, Taoyuan, Taiwan.
authors.forename: Gigin
authors.identifier: 0000-0001-7246-1058
authors.initials: G
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology and Gynecologic Cancer Research Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
authors.affiliation: Graduate Institute of Applied Physics, National Chengchi University, Wenshan District, Taipei, Taiwan.
authors.forename: Shang-Yueh
authors.initials: SY
authors.lastname: Tsai
authors.affiliation: Department of Medical Imaging and Intervention, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Medical Imaging and Intervention, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Huang
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Ren-Chin
authors.initials: RC
authors.lastname: Wu
authors.affiliation: Clinical Trial Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Lan-Yan
authors.initials: LY
authors.lastname: Yang
authors.affiliation: Department of Medical Imaging and Intervention, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.|Clinical Phenome Center, Chang Gung Memorial Hospital at Linkou, Guishan, Taoyuan, Taiwan.
authors.forename: Hsin-Ying
authors.initials: HY
authors.lastname: Lu
authors.affiliation: Department of Obstetrics and Gynecology and Gynecologic Cancer Research Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Angel
authors.initials: A
authors.lastname: Chao
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Chiun-Chieh
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Department of Medical Imaging and Intervention, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Koon-Kwan
authors.initials: KK
authors.lastname: Ng
authors.affiliation: Department of Medical Imaging and Intervention, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
authors.affiliation: Department of Obstetrics and Gynecology and Gynecologic Cancer Research Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Hung-Hsueh
authors.initials: HH
authors.lastname: Chou
authors.affiliation: Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation (CAMIT), Chang Gung Memorial Hospital at Linkou, Guishan, Taoyuan, Taiwan.
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Guishan, Taoyuan, Taiwan.
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Hung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D005838:Genotype; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000000981:diagnostic imaging / Q000235:genetics* / Q000378:metabolism*; D011230:Precancerous Conditions / Q000000981:diagnostic imaging / Q000235:genetics / Q000378:metabolism*; D011379:Prognosis; D066244:Proton Magnetic Resonance Spectroscopy / Q000295:instrumentation* / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000737:chemistry* / Q000000981:diagnostic imaging
chemical_list: D014408:Biomarkers, Tumor
keywords: cervical carcinoma; chemoradiotherapy; human papillomavirus; predictive value; proton magnetic resonance spectroscopy