Blood oxygenation level-dependent MR imaging as a predictor of therapeutic response to concurrent chemoradiotherapy in cervical cancer: a preliminary experience.

Abstract

To investigate the value of blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) as a predictor of therapeutic response in cervical cancer patients undergoing concurrent chemoradiotherapy (CCRT). Thirty consecutive patients with biopsy-proven cervical cancer were examined by BOLD MRI before (preTx) and after CCRT (postTx). The R2* value (s(-1)) was calculated in the tumour and normal myometrium for preTx and postTx studies. Final tumour responses, as determined by changes of tumour size or volume on MRI, were correlated with tumour R2* values at preTx. The mean R2* values of tumours at preTx (21.1) were significantly lower than those at postTx (39.4 s(-1)) (p < 0.001), while those of normal myometrium were similar between preTx and postTx (p = 0.363). At preTx, tumour R2* values showed significantly negative correlation with final tumour size response (p = 0.022, Spearman's coefficient = -0.415). However, tumour R2* values at preTx were not associated with final tumour volume response (p = 0.069). BOLD MRI at 3 T, as an imaging biomarker, may have the potential to evaluate therapeutic response in cervical cancers. The association between BOLD MRI findings and CCRT responses warrants further validation. • Hypoxia in cervical cancer is an independent risk factor • BOLD MRI reflect oxygenation status of tissue adjacent to perfused microvessels • Pretreatment tumour R2* reveal negative correlation with final tumour size response • Accurate oxygenation assessment in cervical cancer may help clinical decision making.