In:
Journal of Magnetic Resonance Imaging, Wiley, Vol. 53, No. 1 ( 2021-01), p. 305-318
Abstract:
Positron emission tomography (PET)/MRI biomarkers have been shown to have prognostic significance in patients with cervical cancer. Their associations with progression‐free survival (PFS) and overall survival (OS) merit further investigation. Purpose To evaluate the association between PET/MRI biomarkers and tumor stage, PFS, and OS in patients with cervical cancer. Study Type Prospective cohort study. Population In all, 54 patients with newly diagnosed cervical cancer and measurable tumors ( 〉 1 cm) were included in the image analysis. Field Strength/Sequence 3.0T integrated PET/MRI including diffusion‐weighted echo‐planar imaging (b = 50 and 1000 s/mm 2 ) and [18F]fluorodeoxyglucose PET. Assessment Two radiologists measured the minimum and mean apparent diffusion coefficient (ADC min and ADC mean ), maximum standardized uptake value (SUV max ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors. Statistical Tests A Mann–Whitney U ‐test was used to evaluate the association between the imaging biomarkers and tumor stage. A Cox proportional hazards model was used to assess the relationships between the imaging biomarkers and survival. Results In advanced tumors (T ≥ 1b2, M1, stage ≥ IB3), ADC min was significantly lower and MTV, TLG, MTV/ADC min , and TLG/ADC min were significantly higher ( P values between 〈 0.001 and 0.036). In N1 tumors, ADC min was significantly lower and MTV and MTV/ADC min were significantly higher ( P values between 0.005 and 0.016). In survival analysis, SUV max was an independent predictor of PFS (hazard ratio [HR] = 4.57, P 〈 0.05), and ADC min was an independent predictor of OS (HR = 0.02, P 〈 0.05). In subgroup analysis of patients with different stages, MTV/ADC min was a predictor of PFS in stage I disease ( P = 0.003), ADC min ( P = 0.038), and MTV ( P = 0.020) in stage II, SUV max ( P = 0.006), and TLG ( P = 0.006) in stage IV; and ADC min was a predictor of OS in stage III disease ( P = 0.008). Data Conclusion PET/MRI biomarkers of cervical cancer are associated with tumor stage and survival. SUV max and ADC min are independent predictors of PFS and OS, respectively. Level of Evidence 1 Technical Efficacy 3
Type of Medium:
Online Resource
ISSN:
1053-1807
,
1522-2586
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
1497154-9
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