Prediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix

被引:146
作者
Loncaster, JA
Carrington, BM
Sykes, JR
Jones, AP
Todd, SM
Cooper, R
Buckley, DL
Davidson, SE
Logue, JP
Hunter, RD
West, CML
机构
[1] Christie Hosp NHS Trust, Acad Dept Radiat Oncol, Manchester M20 4BX, Lancs, England
[2] Christie Hosp NHS Trust, Dept Radiol, Manchester M20 4BX, Lancs, England
[3] Christie Hosp NHS Trust, Dept Clin Oncol, Manchester M20 4BX, Lancs, England
[4] Univ Manchester, Div Imaging Sci & Biomed Engn, Manchester M13 9PL, Lancs, England
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2002年 / 54卷 / 03期
关键词
hypoxia; MRI; cervical carcinoma;
D O I
10.1016/S0360-3016(02)02972-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To investigate whether analysis of MRI enhancement data using a pharmacokinetic model improved a previously found correlation between contrast enhancement and tumor oxygenation measured using Po-2 histograph. To evaluate the prognostic value of gadolinium enhancement data for radiotherapy outcome, and to study the efficacy of combined enhancement and MRI volume data. Methods and materials: Fifty patients underwent dynamic gadolinium-enhanced MRI as part of their initial staging investigations before treatment. Gadolinium enhancement was analyzed using the Brix pharmacokinetic model to obtain the parameters amplitude and rate of contrast enhancement. Pretreatment tumor oxygen measurements (Eppendorf Po-2 histograph) were available for 35 patients. Results: Both standard and pharmacokinetic-derived enhancement data correlated with tumor oxygenation measurements, and poorly enhancing tumors had low tumor oxygen levels. However, only the pharmacokinetic-analyzed data correlated with patient outcome and patients with poorly (amplitude less than median) vs. well-enhancing tumors had significantly worse disease-specific survival (p = 0.024). For the 50 patients studied, no relationship was found between enhancement and volume data. Combining MRI volume and enhancement information highlighted large differences in outcome (p = 0.0054). At the time of analysis, only 55% of patients with large, poorly enhanced tumors were alive compared with 92% of patients with small, well-enhanced tumors. Conclusion: These preliminary results suggest that pharmacokinetic modeling of dynamic contrast-enhanced MRI provides data that reflect tumor oxygenation and yields useful prognostic information in patients with locally advanced carcinoma of the cervix. Combining MRI-derived enhancement and volume data delineates large differences in radiotherapy outcome. (C) 2002 Elsevier Science Inc.
引用
收藏
页码:759 / 767
页数:9
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