PET/MRI in Cervical Cancer: Associations Between Imaging Biomarkers and Tumor Stage, Disease Progression, and Overall Survival

Background 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 PE...

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Bibliographic Details
Published in:Journal of magnetic resonance imaging 2021-01, Vol.53 (1), p.305-318
Main Authors: Shih, I‐Lun, Yen, Rouh‐Fang, Chen, Chi‐An, Cheng, Wen‐Fang, Chen, Bang‐Bin, Chang, Yu‐Hsuan, Cheng, Mei‐Fang, Shih, Tiffany Ting‐Fang
Format: Article
Language:English
Subjects:
Biomarkers
Cancer
Cervical cancer
Cervix
Diffusion coefficient
Disease Progression
Evaluation
Female
Field strength
Fluorodeoxyglucose F18
Glycolysis
Hazard assessment
Health hazards
Humans
Image analysis
Image processing
imaging biomarker
Magnetic Resonance Imaging
Medical imaging
overall survival
PET/MRI
Population studies
Positron emission
Positron emission tomography
Prognosis
progression‐free survival
Prospective Studies
Radiopharmaceuticals
Retrospective Studies
Statistical analysis
Statistical models
Statistical tests
Subgroups
Survival
Survival analysis
Tomography
Tumor Burden
Tumors
Uterine Cervical Neoplasms - diagnostic imaging
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Summary:Background 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/mm2) and [18F]fluorodeoxyglucose PET. Assessment Two radiologists measured the minimum and mean apparent diffusion coefficient (ADCmin and ADCmean), maximum standardized uptake value (SUVmax), 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), ADCmin was significantly lower and MTV, TLG, MTV/ADCmin, and TLG/ADCmin were significantly higher (P values between
ISSN:1053-1807
1522-2586
DOI:10.1002/jmri.27311