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Blood oxygenation level-dependent MR imaging as a predictor of therapeutic response to concurrent chemoradiotherapy in cervical cancer: a preliminary experience

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Abstract

Objectives

To investigate the value of blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) as a predictor of therapeutic response in cervical cancer patients undergoing concurrent chemoradiotherapy (CCRT).

Methods

Thirty consecutive patients with biopsy-proven cervical cancer were examined by BOLD MRI before (preTx) and after CCRT (postTx). The R2* value (s-1) was calculated in the tumour and normal myometrium for preTx and postTx studies. Final tumour responses, as determined by changes of tumour size or volume on MRI, were correlated with tumour R2* values at preTx.

Results

The mean R2* values of tumours at preTx (21.1) were significantly lower than those at postTx (39.4 s-1) (p < 0.001), while those of normal myometrium were similar between preTx and postTx (p = 0.363). At preTx, tumour R2* values showed significantly negative correlation with final tumour size response (p = 0.022, Spearman’s coefficient = -0.415). However, tumour R2* values at preTx were not associated with final tumour volume response (p = 0.069).

Conclusions

BOLD MRI at 3 T, as an imaging biomarker, may have the potential to evaluate therapeutic response in cervical cancers. The association between BOLD MRI findings and CCRT responses warrants further validation.

Key points

• Hypoxia in cervical cancer is an independent risk factor

• BOLD MRI reflect oxygenation status of tissue adjacent to perfused microvessels

• Pretreatment tumour R2* reveal negative correlation with final tumour size response

• Accurate oxygenation assessment in cervical cancer may help clinical decision making

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Abbreviations

BOLD:

Blood oxygenation-level dependent

CCRT:

Concurrent chemoradiotherapy

DCE:

Dynamic contrast enhanced

PreTx:

Before treatment

PostTx:

Post treatment

mFFE:

Multiple fast field echo

SCC:

Squamous cell carcinoma

FIGO:

Federation of International Gynecology and Obstetrics

LN:

Lymph node

EBRT:

External beam radiotherapy

ICR:

Intracavitary brachytherapy

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Acknowledgments

The scientific guarantor of this publication is Seung Jae Huh. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Sookyoung Woo, PhD kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Approval from the institutional animal care committee was not required because this study was on human subjects. None of the study subjects or cohorts have been previously reported in any studies. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Republic of Korea

    Chan Kyo Kim, Sung Yoon Park & Byung Kwan Park

  2. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Republic of Korea, 135-710

    Won Park & Seung Jae Huh

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  1. Chan Kyo Kim
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  2. Sung Yoon Park
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  4. Won Park
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Correspondence to Seung Jae Huh.

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Kim, C.K., Park, S.Y., Park, B.K. et al. Blood oxygenation level-dependent MR imaging as a predictor of therapeutic response to concurrent chemoradiotherapy in cervical cancer: a preliminary experience. Eur Radiol 24, 1514–1520 (2014). https://doi.org/10.1007/s00330-014-3167-0

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  • DOI: https://doi.org/10.1007/s00330-014-3167-0

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