Takashi Kawanaka MD, Presenter: Nothing to Disclose

Mayumi Takeuchi MD, Abstract Co-Author: Nothing to Disclose

Kenji Matsuzaki MD, PhD, Abstract Co-Author: Nothing to Disclose

Akiko Kubo MD, Abstract Co-Author: Nothing to Disclose

Hitoshi Ikushima MD, Abstract Co-Author: Nothing to Disclose

Hiromu Nishitani MD, PhD, Abstract Co-Author: Nothing to Disclose

Shunsuke Furutani, Abstract Co-Author: Nothing to Disclose

Kyosuke Osaki MD, Abstract Co-Author: Nothing to Disclose

Purpose: To analyze prospectively the prognostic significance of 1H magnetic resonance spectroscopy (MRS) at 3 Tesla in vivo recorded before initiation of radiotherapy and during the first 2 weeks of radiotherapy. Materials/Methods: Six patients aged 54-68 years were examined using a on a 3 Tesla MR scanner. All of 6 patients were pathologicaly proven Stage IIB-IIIB uterine cervical cancer. Each patient had received 50 Gy of external beam radiotherapy to the pelvis with CDDP base weekly chemotherapy. Each patient also underwent 4 applications of high-dose-rate brachytherapy (median, 5 Gy to point A at each session). MRI-localized 1HMR spectra were acquired using a single-voxel, double-spin-echo sequence. Relative intensities of the signals (choline, creatine [Cr] N-acetyl aspartate [NAA], myo-inositol, lactate, and lipids) were obtained by numeric integration of fitted signals. Results: Compared to the MRS before initiation of radiotherapy, 4 patients undergoing radiotherapy revealed a decrease in the choline/creatine (Cr) and choline/NAA ratios during the first 2 weeks of radiotherapy (median, 20 Gy to whole pelvis). Two patients who did not revealed a decrease in the choline ratios were clinically diagnosed as remaining local cancer at initial assessment after completing chemoradiotherapy. So those two patients had chemotherapy or boost radiotherapy as a additional treatment. All patients who revealed a decrease in the choline ratios were clinically diagnosed as complete response to chemoradiotherapy at initial assessment using MRI or pelvic examination. Conclusions: Early period alteration in choline/Cr and choline/NAA ratios using MRS in patients with uterine cervical cancer demonstrated ability to distinguish patients with poor reactivity to chemoradiotherapy.

Kawanaka, T, Takeuchi, M, Matsuzaki, K, Kubo, A, Ikushima, H, Nishitani, H, Furutani, S, Osaki, K, Prognostic Significance of 3 Tesla Magnetic Resonance Spectroscopy in Patients with Uterine Cervical Cancer Undergoing Radiotherapy: Initial Experience.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8501898.html