The potential of contemporary diagnostic imaging modalities for improving assessment of treatment response in patients with locally advanced cervical cancer


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Abstract

Aim. To investigate the potential of CT perfusion in assessing treatment response in patients with locally advanced cervical cancer undergoing selective chemotherapy in comparison with 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT). Material and methods. The study included 15 patients with stages IB1 - IIIB cervical cancer, according to FIGO. All patients underwent pelvic ultrasonography and magnetic resonance imaging (MRI), CT perfusion of the uterine cervix, and whole-body 18F-FDG PET- CT at the initial stage and after first-line therapy including 2 courses of regional chemotherapy. Results. Analysis of PET/CT scan results showed that the local complete and partial metabolic response was achieved in 1 (6.7%) and 10 (66.7%) patients, respectively, and 4 (26.6%) patients had stabilization. Spread to extra-pelvic sites (the lungs) occurred in 1 (6.7%) patient, in whom the local progression was defined as stabilization. Dynamic changes in all perfusion parameters, except for BF, were more pronounced in patients with the complete and partial metabolic response. The difference in indicators such as BV and MTT was significantly different in all study groups (with an increase in parallel with the completeness of the metabolic response), while the difference in PS in the groups of complete and partial metabolic response did not differ significantly, but was significantly larger than in the metabolic stabilization group. Conclusion. Perfusion indicators of BVand MTT, before and after treatment, are the most informative in assessing treatment response to selective chemotherapy for locally advanced cervical cancer. There was a correlation between the changes in perfusion indicators such as BV, PS, MTT, and SUVmax in all groups, in comparison with the metabolic response determined by PET/CT.

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About the authors

E. V Klimenko

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

Email: elenasherbahina@mail.ru

A. I Khalimon

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

Email: elenasherbahina@mail.ru

N. A Rubtsova

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

A. V Leont’ev

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

S. V Mukhtarulina

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

Email: svmukhtarulina@yandex.ru

K. H.R Mal’tsagova

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

A. G Rerberg

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

E. G Novikova

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

A. D Kaprin

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia

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