OBJECTIVES: To analyse the role of DW-MRI in early prediction of pathologically-assessed residual disease in locally-advanced cervical cancer (LACC) treated with neoadjuvant chemoradiotherapy followed by radical surgery. METHODS: Between October 2010-June 2014, 108 women with histologically-proven cervical cancer were screened; 88 were included in this study. Tumour volume (TV) and ADCmean were measured before (baseline-MRI) and after 2 weeks of chemoradiotherapy (early-MRI). According to histopathology, treatment response was classified as complete (CR) or partial (PR). Comparisons were made with Mann-Whitney, Wilcoxon and χ2 tests. ROC curves were generated for statistically significant parameters on univariate analysis. RESULTS: CR and PR were documented in 40 and 48 patients. At baseline-MRI, TV did not differ between groups. At early-MRI, TV was higher in PR than in CR (p=0.001). ΔTV reduction after treatment was lower in PR than in CR (63.6% vs. 81.1%; p=0.001). At baseline-MRI and early-MRI, ADCmean did not differ between PR and CR. ROC curve showed best cut-off for predicting pathological PR was ΔTV reduction of 73% with sensitivity, specificity, accuracy, NPV, PPV of 73%, 72.5%, 72.7%, 76%, 69%. CONCLUSIONS: TV evaluated before and early after treatment could predict pathological response in LACC. ADCmean did not correlate with treatment outcome.

Valentini, A. L., Miccò, M., Gui, B., Giuliani, M., Rodolfino, E., Telesca, A. M., Pasciuto, T., Testa, A. C., Gambacorta, M. A., Zannoni, G., Rufini, V., Giordano, A., Valentini, V., Scambia, G., Manfredi, R., The PRICE study: The role of conventional and diffusion-weighted magnetic resonance imaging in assessment of locally advanced cervical cancer patients administered by chemoradiation followed by radical surgery., <<EUROPEAN RADIOLOGY>>, 2018; (Jan 9): N/A-N/A. [doi:10.1007/s00330-017-5233-x] [http://hdl.handle.net/10807/111164]

The PRICE study: The role of conventional and diffusion-weighted magnetic resonance imaging in assessment of locally advanced cervical cancer patients administered by chemoradiation followed by radical surgery.

Valentini Anna Lia;Miccò Maura;Gui Benedetta;Giuliani Michela;Rodolfino Elena;Telesca Anna MAria;Pasciuto Tina;Testa Antonia Carla;Gambacorta Maria Antonietta;Zannoni Gianfranco;Rufini Vittoria;Giordano Alessandro;Valentini Vincenzo;Scambia Giovanni;Manfredi Riccardo
2018

Abstract

OBJECTIVES: To analyse the role of DW-MRI in early prediction of pathologically-assessed residual disease in locally-advanced cervical cancer (LACC) treated with neoadjuvant chemoradiotherapy followed by radical surgery. METHODS: Between October 2010-June 2014, 108 women with histologically-proven cervical cancer were screened; 88 were included in this study. Tumour volume (TV) and ADCmean were measured before (baseline-MRI) and after 2 weeks of chemoradiotherapy (early-MRI). According to histopathology, treatment response was classified as complete (CR) or partial (PR). Comparisons were made with Mann-Whitney, Wilcoxon and χ2 tests. ROC curves were generated for statistically significant parameters on univariate analysis. RESULTS: CR and PR were documented in 40 and 48 patients. At baseline-MRI, TV did not differ between groups. At early-MRI, TV was higher in PR than in CR (p=0.001). ΔTV reduction after treatment was lower in PR than in CR (63.6% vs. 81.1%; p=0.001). At baseline-MRI and early-MRI, ADCmean did not differ between PR and CR. ROC curve showed best cut-off for predicting pathological PR was ΔTV reduction of 73% with sensitivity, specificity, accuracy, NPV, PPV of 73%, 72.5%, 72.7%, 76%, 69%. CONCLUSIONS: TV evaluated before and early after treatment could predict pathological response in LACC. ADCmean did not correlate with treatment outcome.
Inglese
Valentini, A. L., Miccò, M., Gui, B., Giuliani, M., Rodolfino, E., Telesca, A. M., Pasciuto, T., Testa, A. C., Gambacorta, M. A., Zannoni, G., Rufini, V., Giordano, A., Valentini, V., Scambia, G., Manfredi, R., The PRICE study: The role of conventional and diffusion-weighted magnetic resonance imaging in assessment of locally advanced cervical cancer patients administered by chemoradiation followed by radical surgery., <>, 2018; (Jan 9): N/A-N/A. [doi:10.1007/s00330-017-5233-x] [http://hdl.handle.net/10807/111164]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/111164
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