Maura Miccò1, Hebert Alberto Vargas2, Irene A Burger2, Marisa A Kollmeier3, Debra A Goldman4, Kay J Park5, Nadeem R Abu-Rustum6, Hedvig Hricak2, Evis Sala2. 1. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. Electronic address: miccom@mskcc.org. 2. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. 3. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 1006, United States. 4. Department of Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, New York, NY 10065, United States. 5. Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. 6. Department of Surgery, Gynecologic Oncology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States.
Abstract
OBJECTIVE: To determine the associations of quantitative parameters derived from multiphase contrast-enhanced magnetic resonance imaging (CE-MRI), diffusion-weighted (DW) MRI and 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/computed tomography (PET/CT) with clinico-histopathological prognostic factors, disease-free survival (DFS) and overall survival (OS) in patients with cervical cancer. METHODS AND MATERIALS: Our institutional review board approved this retrospective study of 49 patients (median age, 45 years) with histopathologically proven IB-IVB International Federation of Gynecology and Obstetrics (FIGO) cervical cancer who underwent pre-treatment pelvic MRI and whole-body 18F-FDG PET/CT between February 2009 and May 2012. Maximum diameter (maxTD), percentage enhancement (PE) and mean apparent diffusion coefficient (ADCmean) of the primary tumor were measured on MRI. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT. Correlations between imaging metrics and clinico-histopathological parameters including revised 2009 FIGO stage, tumor histology, grade and lymph node (LN) metastasis at diagnosis were evaluated using the Wilcoxon rank sum test. Cox modeling was used to determine associations with DFS and OS. RESULTS: Median follow-up was 17 months. 41 patients (83.6%) were alive. 8 patients (16.3%) died of disease. Progression/recurrence occurred in 17 patients (34.6%). Significant differences were observed in ADCmean, SUVmax, MTV and TLG according to FIGO stage (p<0.001-0.025). There were significant correlations between ADCmean, MTV, TLG and LN metastasis (p=0.017-0.032). SUVmax was not associated with LN metastasis. FIGO stage (p=0.017/0.033), LN metastases (p=0.001/0.020), ADCmean (p=0.007/0.020) and MTV (p=0.014/0.026) were adverse predictors of both DFS/OS. maxTD (p=0.005) and TLG (p=0.024) were adverse predictors of DFS. PE and SUVmax did not correlate with DFS or OS (p=0.18-0.72). CONCLUSIONS: Quantitative parameters derived from pre-treatment DW-MRI (ADCmean) and from 18F-FDG PET/CT (MTV and TLG) were associated with high-risk features and may serve as prognostic biomarkers of survival in patients with cervical cancer.
OBJECTIVE: To determine the associations of quantitative parameters derived from multiphase contrast-enhanced magnetic resonance imaging (CE-MRI), diffusion-weighted (DW) MRI and 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/computed tomography (PET/CT) with clinico-histopathological prognostic factors, disease-free survival (DFS) and overall survival (OS) in patients with cervical cancer. METHODS AND MATERIALS: Our institutional review board approved this retrospective study of 49 patients (median age, 45 years) with histopathologically proven IB-IVB International Federation of Gynecology and Obstetrics (FIGO) cervical cancer who underwent pre-treatment pelvic MRI and whole-body 18F-FDG PET/CT between February 2009 and May 2012. Maximum diameter (maxTD), percentage enhancement (PE) and mean apparent diffusion coefficient (ADCmean) of the primary tumor were measured on MRI. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT. Correlations between imaging metrics and clinico-histopathological parameters including revised 2009 FIGO stage, tumor histology, grade and lymph node (LN) metastasis at diagnosis were evaluated using the Wilcoxon rank sum test. Cox modeling was used to determine associations with DFS and OS. RESULTS: Median follow-up was 17 months. 41 patients (83.6%) were alive. 8 patients (16.3%) died of disease. Progression/recurrence occurred in 17 patients (34.6%). Significant differences were observed in ADCmean, SUVmax, MTV and TLG according to FIGO stage (p<0.001-0.025). There were significant correlations between ADCmean, MTV, TLG and LN metastasis (p=0.017-0.032). SUVmax was not associated with LN metastasis. FIGO stage (p=0.017/0.033), LN metastases (p=0.001/0.020), ADCmean (p=0.007/0.020) and MTV (p=0.014/0.026) were adverse predictors of both DFS/OS. maxTD (p=0.005) and TLG (p=0.024) were adverse predictors of DFS. PE and SUVmax did not correlate with DFS or OS (p=0.18-0.72). CONCLUSIONS: Quantitative parameters derived from pre-treatment DW-MRI (ADCmean) and from 18F-FDG PET/CT (MTV and TLG) were associated with high-risk features and may serve as prognostic biomarkers of survival in patients with cervical cancer.
Authors: Niels W Schurink; Simon R van Kranen; Maaike Berbee; Wouter van Elmpt; Frans C H Bakers; Sander Roberti; Joost J M van Griethuysen; Lisa A Min; Max J Lahaye; Monique Maas; Geerard L Beets; Regina G H Beets-Tan; Doenja M J Lambregts Journal: Eur Radiol Date: 2021-02-10 Impact factor: 5.315
Authors: Lisa A Min; Wouter V Vogel; Max J Lahaye; Monique Maas; Maarten L Donswijk; Erik Vegt; Miranda Kusters; Henry J Zijlmans; Katarzyna Jóźwiak; Sander Roberti; Regina G H Beets-Tan; Doenja M J Lambregts Journal: Eur Radiol Date: 2019-05-22 Impact factor: 5.315
Authors: Evis Sala; Maura Micco; Irene A Burger; Derya Yakar; Marisa A Kollmeier; Debra A Goldman; Mithat Gonen; Kay J Park; Nadeem R Abu-Rustum; Hedvig Hricak; Hebert Alberto Vargas Journal: Int J Gynecol Cancer Date: 2015-10 Impact factor: 3.437
Authors: Niels W Schurink; Lisa A Min; Maaike Berbee; Wouter van Elmpt; Joost J M van Griethuysen; Frans C H Bakers; Sander Roberti; Simon R van Kranen; Max J Lahaye; Monique Maas; Geerard L Beets; Regina G H Beets-Tan; Doenja M J Lambregts Journal: Eur Radiol Date: 2020-02-07 Impact factor: 5.315