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Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Advanced Cervical Carcinoma: The Advantage of Perfusion Parameters From the Peripheral Region in Predicting the Early Response to Radiotherapy
  1. Zhaoguang Zhang, MD*,
  2. Zhengang Wang, MD and
  3. Rongrong Zhao, MD
  1. *Department of Ultrasonography,
  2. Department of Neurosurgery, and
  3. Department of Radiology, Affiliated Hospital of Weifang Medical University, Weifang City, Shandong Province, China.
  1. Address correspondence and reprint requests to Zhaoguang Zhang, MD, Department of Ultrasonography, Affiliated Hospital of Weifang Medical University, Weifang City, Shandong Province, China. E-mail: zhangzhaoguang1997{at}126.com.

Abstract

Objective This study aimed to investigate the importance of perfusion parameters from the peripheral region in predicting the early response to radiotherapy for advanced cervical carcinoma by using dynamic contrast-enhanced (DCE) perfusion magnetic resonance imaging (MRI).

Methods One hundred eight patients with advanced cervical carcinoma were enrolled into this study. Dynamic contrast-enhanced perfusion MR examinations were performed for all the patients before radiotherapy. Perfusion parameters were obtained from the central region and the peripheral region of tumor respectively. After radiotherapy, the patients were classified into responders and nonresponders according to tumor shrinkage on the basis of follow-up MRI examination. The mean follow-up time lasted 12 months. The perfusion parameters were compared between the 2 groups. The relationship between perfusion parameters from 2 different regions of tumor and treatment effect was analyzed.

Results The mean value of volume transfer constant (Ktrans), rate constant (Kep) or extravascular extracellular volume fraction (Ve) from the peripheral region was higher than that from the central region of tumor, respectively (P = 0.01, 004, 0.03). Responders had higher Ktrans peripheral (Ktrans from the peripheral region) and Ktrans central (Ktrans from the central region) values than nonresponders (P = 0.04, 0.01). Responders had higher Kepperipheral (Kep from the peripheral region) than nonresponders (P = 0.03). Responders had lower Veperipheral (Ve from the peripheral region) than nonresponders (P = 0.04). At logistic regression analysis, the perfusion parameters that had predicting value were Ktrans peripheral, Veperipheral, Kepperipheral and Ktrans central according to diagnostic potency.

Conclusions Compared with perfusion parameters from the central region of tumor, perfusion parameters from the peripheral region are more valuable in predicting the early response to radiotherapy for advanced cervical carcinoma.

  • Cervical carcinoma
  • Dynamic contrast enhanced
  • Magnetic resonance imaging
  • Radiotherapy
  • Therapeutic response

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Footnotes

  • Declaration: We declare that we have no financial and personal relationships with other people or organizations that inappropriately influence our works. There is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in or the review of, the manuscript entitled. Publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out.