A Combined Pharmacokinetic and Radiologic Assessment of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Predicts Response to Chemoradiation in Locally Advanced Cervical Cancer
| Autor: | Scott Semple, Fiona J. Gilbert, David E. Parkin, Vanessa N. Harry |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty medicine.medical_treatment Contrast Media Uterine Cervical Neoplasms Adenocarcinoma Pharmacokinetics medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Aged Aged 80 and over Cervical cancer Reproducibility Radiation medicine.diagnostic_test business.industry Magnetic resonance imaging Middle Aged Image Enhancement medicine.disease Combined Modality Therapy Magnetic Resonance Imaging Radiation therapy Treatment Outcome Oncology Dynamic contrast-enhanced MRI Carcinoma Squamous Cell Linear Models Female Radiology business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 75:611-617 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2009.04.069 |
| Popis: | To investigate the combination of pharmacokinetic and radiologic assessment of dynamic contrast-enhanced magnetic resonance imaging (MRI) as an early response indicator in women receiving chemoradiation for advanced cervical cancer.Twenty women with locally advanced cervical cancer were included in a prospective cohort study. Dynamic contrast-enhanced MRI was carried out before chemoradiation, after 2 weeks of therapy, and at the conclusion of therapy using a 1.5-T MRI scanner. Radiologic assessment of uptake parameters was obtained from resultant intensity curves. Pharmacokinetic analysis using a multicompartment model was also performed. General linear modeling was used to combine radiologic and pharmacokinetic parameters and correlated with eventual response as determined by change in MRI tumor size and conventional clinical response. A subgroup of 11 women underwent repeat pretherapy MRI to test pharmacokinetic reproducibility.Pretherapy radiologic parameters and pharmacokinetic K(trans) correlated with response (p0.01). General linear modeling demonstrated that a combination of radiologic and pharmacokinetic assessments before therapy was able to predict more than 88% of variance of response. Reproducibility of pharmacokinetic modeling was confirmed.A combination of radiologic assessment with pharmacokinetic modeling applied to dynamic MRI before the start of chemoradiation improves the predictive power of either by more than 20%. The potential improvements in therapy response prediction using this type of combined analysis of dynamic contrast-enhanced MRI may aid in the development of more individualized, effective therapy regimens for this patient group. |
| Databáze: | OpenAIRE |
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