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Predicting control of primary tumor and survival by DCE MRI during early therapy in cervical cancer
Investigative Radiology, 06/15/09

Sammet S et al. - Data show that MRI parameters quantifying perfusion status and residual tumor volume provide very early prediction of primary tumor control and disease-free-survival. This functional imaging based outcome predictor can be obtained in the very early phase of cytotoxic therapy within 2 to 2.5 weeks of therapy start.

Methods

Aim was to assess the early predictive power of MRI perfusion and volume parameters, during early treatment of cervical cancer
3 MRI examinations were obtained in 101 pts before and during therapy for serial dynamic contrast enhanced (DCE) perfusion MRI and 3-D tumor volume measurement
The degree and quantity of the poorly-perfused tumor subregions was analyzed by using various lower percentiles of SI (SI%)
SI%, mean SI, and 3-D volume of the tumor were correlated with primary tumor control and DFS
Mean post-therapy f/u time for outcome assessment was 6.8 yrs

Results

Tumor volume, mean SI, and SI% showed significant prediction of the long-term clinical outcome
This prediction was provided as early as 2-2.5 wks into treatment
An SI5% of <2.05 and residual tumor volume of ≥30 cm3 in the MRI obtained at 2 to 2.5 wks of therapy provided the best prediction of unfavorable 8-yr primary tumor control and DFS rate respectively

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