Evaluation of T2-W MR imaging and diffusion-weighted imaging for the early post-treatment local response assessment of patients treated conservatively for cervical cancer: a multicentre study

Autor: Erik Van Limbergen, Ignace Vergote, Jaap Stoker, M. G. Myriam Hunink, Peter de Boer, Helena van Doorn, Vincent Vandecaveye, Marrije R. Buist, Martine Franckena-Schouten, Maarten Thomeer, Frenchey Mayer, Loes M M Braun
Přispěvatelé: Radiology & Nuclear Medicine, Obstetrics & Gynecology, Radiotherapy, Epidemiology, Graduate School, CCA - Cancer Treatment and Quality of Life, Radiology and Nuclear Medicine, AGEM - Re-generation and cancer of the digestive system, AGEM - Digestive immunity, CCA - Imaging and biomarkers, Obstetrics and Gynaecology
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
medicine.medical_specialty
Diffusion-weighted magnetic resonance imaging
Time Factors
medicine.medical_treatment
Uterine Cervical Neoplasms
Conservative Treatment
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Magnetic resonance imaging
SDG 3 - Good Health and Well-being
medicine
Effective diffusion coefficient
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
cardiovascular diseases
Neuroradiology
Aged
Cervical cancer
Aged
80 and over
Uterine cervical neoplasm
Radiation
medicine.diagnostic_test
business.industry
Ultrasound
Interventional radiology
Urogenital
General Medicine
Middle Aged
medicine.disease
Radiation therapy
Diffusion Magnetic Resonance Imaging
030220 oncology & carcinogenesis
Disease Progression
Female
Radiology
Comparative study
business
Diffusion MRI
Follow-Up Studies
Zdroj: European Radiology, 29(1), 309-318. Springer-Verlag
European Radiology
European radiology, 29(1), 309-318. Springer Verlag
ISSN: 0938-7994
DOI: 10.1007/s00330-018-5510-3
Popis: OBJECTIVES: To compare MR imaging with or without DWI and clinical response evaluation (CRE) in the local control evaluation of cervical carcinoma after radiotherapy. METHODS: In a multicentre university setting, we prospectively included 107 patients with primary cervical cancer treated with radiotherapy. Sensitivity and specificity for CRE and MR imaging (with pre-therapy MR imaging as reference) (2 readers) were evaluated using cautious and strict criteria for identifying residual tumour. Nested logistic regression models were constructed for CRE, subsequently adding MR imaging with and without DWI as independent variables, as well as the pre- to post-treatment change in apparent diffusion coefficient (delta ADC). RESULTS: Using cautious criteria, CRE and MR imaging with DWI (reader 1/reader 2) have comparable high specificity (83% and 89%/95%, respectively), whereas MR imaging without DWI showed significantly lower specificity (63%/53%) than CRE. Using strict criteria, CRE and MR imaging with DWI both showed very high specificity (99% and 92%/95%, respectively), whereas MR imaging without DWI showed significantly lower specificity (89%/77%) than CRE. All sensitivities were not significantly different. Addition of MR imaging with DWI to CRE has statistically significant incremental value in identifying residual tumour (reader 1: estimate, 1.06; p = 0.001) (reader 2: estimate, 0.62; p = 0.02). Adding the delta ADC did not have significant incremental value in detecting residual tumour. CONCLUSIONS: DWI significantly increases the specificity of MR imaging in the detection of local residual tumour. Furthermore, MR imaging with DWI has significant incremental diagnostic value over CRE, whereas adding the delta ADC has no incremental diagnostic value. KEY POINTS: • If MR imaging is used for response evaluation, DWI should be incorporated • MR imaging with DWI has diagnostic value comparable/complementary to clinical response evaluation • Inter-reader agreement is moderate to fair for two experienced radiologist readers • Quantitative measurements of ADC early post-therapy have limited diagnostic value. ispartof: EUROPEAN RADIOLOGY vol:29 issue:1 pages:309-318 ispartof: location:Germany status: published
Databáze: OpenAIRE
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