Dynamic contrast-enhanced MRI predicts the neoadjuvant chemotherapy short-term effect in patients with cervical cancer / 实用放射学杂志

ABSTRACT

Objective To investigate prospectively the changes of quantitative parameters in dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer patients before and after neoadjuvant chemotherapy (NACT).Methods Thirty-eight patients with locally advanced cervical cancer (in stage Ⅰ B2,Ⅱ A2,Ⅱ B) underwent DCE-MRI one week before and 1 month after NACT.The patients were classified into two groupssignificant reaction(sCR) group and non-sCR group.The DCE-MRI pharmacokinetics parameters (mean Ktrans,mean Kep,mean Ve and mean Vp) were measured and compared between the sCR and non-sCR groups.Receiver operating characteristic (ROC) curves were constructed to describe the diagnostic accuracy of the significant parameters and their decision thresholds.Results There were 22 and 16 patients in sCR and non-sCR groups,respectively.Before NACT,the mean Ktrans was higher (P＜0.05) but the mean Ve (P＜0.05) was lower in sCR group than those in non-sCR group,and these differences were statistically significant,respectively.After NACT,the mean Ktrans (P＜0.05) and the changed value of Ktrans (P＜0.05) were significantly lower in the sCR group compared with those in the non-sCR group.The remained parameters such as Vp and Kep had no statistically difference between the two groups.When combined the parameters values before and after treatment by using ROC curves,the area under curve (AUC) of pre-mean Ktrans and /Ktrans were 0.801 (P＜0.05),0.955 (P＜0.001).The optimal cut off value for distinguishing sCR from non-sCR were the pretreatment Ktrans (0.702 0) and/Ktrans (0.043 7),and their sensitivity and specificity were 77.3％,81.2 ％,95.5％ and 81.2％,respectively.Conclusion Quantitative parameters of DCE-MRI provided a new noninvasive way to reflect the changes of hemodynamics in cervical cancer patients with NACT.The quantitative parameters,such as pre-mean Ktrans and /Ktrans could predict the treatment efficacy more precisely.