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Assessment of the Early Predictive Power of Quantitative Magnetic Resonance Imaging Parameters During Neoadjuvant Chemotherapy for Uterine Cervical Cancer
  1. Yuki Himoto, MD*,
  2. Koji Fujimoto, MD, PhD*,
  3. Aki Kido, MD, PhD*,
  4. Noriomi Matsumura, MD, PhD,
  5. Tsukasa Baba, MD, PhD,
  6. Sayaka Daido, MD*,
  7. Kayo Kiguchi, MD*,
  8. Fuki Shitano, MD*,
  9. Ikuo Konishi, MD, PhD and
  10. Kaori Togashi, MD, PhD*
  1. *Departments of Diagnostic Imaging and Nuclear Medicine, and
  2. Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
  1. Address correspondence and reprint requests to Koji Fujimoto, MD, PhD, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. E-mail: kfb{at}


Objectives The purpose of this study was to quantitatively evaluate 3 types of magnetic resonance imaging (MRI) parameters in parallel for the early prediction of neoadjuvant chemotherapy (NACT) effectiveness in cervical cancer—tumor volume parameters, diffusion parameters, and perfusion parameters.

Materials and Methods We prospectively evaluated 13 patients with International Federation of Gynecology and Obstetrics stage IB to IIB cervical squamous cell carcinoma who underwent 3 serial MRI studies, that is, pretreatment, post–first course NACT, and post–second course NACT followed by radical hysterectomy. We obtained tumor volume parameters, diffusion parameters, and dynamic contrast material–enhanced perfusion parameters quantitatively from pretreatment MRI and post–first course MRI. The correlation of these parameters and the eventual tumor volume regression rate (TVRR) obtained from pretreatment MRI and post–second course MRI before surgery were investigated, statistically based on the Pearson correlation coefficient.

Results Thirteen patients had a total of 39 scans. Early TVRR (r = 0.844; P < 0.001), the fractional volume of the tissue extracellular extravascular space (Ve, r = 0.648; P < 0.05), and the change of Ve during the first course of NACT (r = −0.638; P < 0.05) correlated with eventual TVRR.

Conclusions Early TVRR, Ve, and the change of Ve could be useful predictors for the treatment effectiveness of NACT. These parameters could help to modify strategy in the early stage of NACT and to choose individualized treatment to avoid the delay of radical treatment, even when NACT is ineffective.

  • Uterine cervical cancer
  • Neoadjuvant chemotherapy
  • Magnetic resonance imaging
  • Diffusion-weighted imaging
  • Perfusion-weighted imaging
  • Tumor volume

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  • The authors declare no conflicts of interest.