Predictive Role of MRI and 18F FDG PET Response to Concurrent Chemoradiation in T2b Cervical Cancer on Clinical Outcome: A Retrospective Single Center Study.

Anna Myriam Perrone,Cristina Nanni,Silvi Telo,Paolo Castellucci,Pierandrea De Iaco,Eugenia De Crescenzo,Stefano Fanti,Marco Tesei,Andrea Galuppi,Alessio G Morganti,Manuela Coe,Giulia Dondi,Martina Ferioli

doi:10.3390/cancers12030659

Anna Myriam Perrone, Cristina Nanni + Show 11 more

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https://doi.org/10.3390/cancers12030659

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Journal: Cancers	Publication Date: Mar 12, 2020
Citations: 8	License type: CC BY 4.0

Affiliation: Policlinico S.Orsola-Malpighi, University of Bologna

Abstract

Tumor response in locally advanced cervical cancer (LACC) is generally evaluated with MRI and PET, but this strategy is not supported by the literature. Therefore, we compared the diagnostic performance of these two techniques in the response evaluation to concurrent chemoradiotherapy (CCRT) in LACC. Patients with cervical cancer (CC) stage T2b treated with CCRT and submitted to MRI and PET/CT before and after treatment were enrolled in the study. All clinical, pathological, therapeutic, radiologic and follow-up data were collected and examined. The radiological response was analyzed and compared to the follow-up data. Data of 40 patients with LACC were analyzed. Agreement between MRI and PET/CT in the evaluation response to therapy was observed in 31/40 (77.5%) of cases. The agreement between MRI, PET/CT and follow-up data showed a Cohen kappa coefficient of 0.59 (95% CI = 0.267–0.913) and of 0.84 (95% CI = 0.636–1.00), respectively. Considering the evaluation of primary tumor response, PET/CT was correct in 97.5% of cases, and MRI in 92.5% of cases; no false negative cases were observed. These results suggest the use of PET/CT as a unique diagnostic imaging tool after CCRT, to correctly assess residual and progression disease.

Highlights

Cervical carcinoma (CC) is the third commonest gynecological cancer in women worldwide [1,2].In the past, CC was routinely staged with the clinical FIGO system but the new ESGO guidelines introduced and recommended a TNM classification with a FIGO staging, too [3,4,5]
PET/Computed Tomography (CT) and poststage T2b treated with concurrent chemoradiotherapy (CCRT) with a pre-treatment pelvic MRI and total body 18 F-FDG PET/CT and treatment pelvic MRI and total body F-FDG
PET/CT performed in the radiologic service of our post-treatment pelvic MRI and total body 18 F-FDG PET/CT performed in the radiologic service of our institution, and with adequate follow-up over 24 months) and were enrolled in the study

Summary

Introduction

Cervical carcinoma (CC) is the third commonest gynecological cancer in women worldwide [1,2]. CC was routinely staged with the clinical FIGO system but the new ESGO guidelines introduced and recommended a TNM classification with a FIGO staging, too [3,4,5]. CC and locally advanced CC (LACC) represent two different realities with distinct therapeutic approaches and prognosis. Surgery is the preferred approach in the early stage while concurrent chemoradiation (CCRT). Is the standard treatment option in LACC [3,6,7,8]. The target of the external beam radiation therapy. CCRT allows local control of the disease in 70%–80%

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