Prediction of treatment response in patients with locally advanced cervical cancer using midtreatment PET/MRI during concurrent chemoradiotherapy.

Autor: Vojtíšek R; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic. vojtisekr@fnplzen.cz., Baxa J; Department of Imaging Methods, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic., Kovářová P; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic., Almortaza A; Department of Imaging Methods, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic., Hošek P; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 76, 32300, Pilsen, Czech Republic., Sukovská E; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic., Tupý R; Department of Imaging Methods, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic., Ferda J; Department of Imaging Methods, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic., Fínek J; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 30460, Pilsen, Czech Republic.
Jazyk: angličtina
Zdroj: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] [Strahlenther Onkol] 2021 Jun; Vol. 197 (6), pp. 494-504. Date of Electronic Publication: 2021 Jan 25.
DOI: 10.1007/s00066-020-01740-7
Abstrakt: Purpose: We aimed to find metabolic, functional or morphological characteristics of the tumor predicting failure to achieve complete metabolic remission (CMR) by the midtreatment PET/MRI (positron emission tomography/magnetic resonance imaging) in cervical cancer patients.
Methods: We evaluated 66 patients treated between August 2015 and November 2019 who underwent pretreatment staging, subsequent midtreatment evaluation, and definitive restaging 3 months after completing the whole treatment, all using PET/MRI. The pretreatment parameters (pre-SUVmax, pre-SUVmean, pre-MTV, pre-MTV‑S, pre-TLG, pre-TLG‑S [SUV: standard uptake value, MTV: metabolic tumor volume, TLG: total lesion glycolysis]), and the midtreatment parameters at week 5 during chemoradiotherapy (mid-SUVmax, mid-SUVmean, mid-MTV, mid-MTV‑S, mid-TLG and mid-TLG-S) were recorded. The value of ADC (apparent diffusion coefficient) was also measured. Furthermore, we recorded absolute and relative changes in all parameters-∆ and ∆%. We divided the whole group of patients into "responders" (CMR) and "non-responders" (non-CMR), and compared them on the basis of the parameters from pre-PET/MRI and mid-PET/MRI.
Results: A statistically significant difference in the evaluated parameters between responders and non-responders was found for the following parameters: mid-MTV, mid-TLG, mid-TLG‑S, mid-MTV‑S, mid-tumor size, and ∆%SUVmax. According to the ROC (receiver operating characteristic) analysis, mid-MTV‑S showed the best albeit moderate discrimination ability for the prediction of non-CMR. Significant mutual correlations of all variables, in particular between mid-MTV‑S and mid-TLG‑S and between mid-MTV and mid-TLG, were found (all p < 0.05).
Conclusion: Our study confirmed that when using the midtreatment PET/MRI we are able to identify metabolic parameters having the discrimination ability for the prediction of non-CMR. In particular mid-MTV‑S, mid-MTV, mid-tumor size, mid-TLG‑S, mid-TLG and ∆%SUVmax.
Databáze: MEDLINE
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