Saba N. Elias MSc, Presenter: Nothing to Disclose

Guang Jia PhD, Abstract Co-Author: Nothing to Disclose

Nina A. Mayr MD, Abstract Co-Author: Nothing to Disclose

William TC Yuh MD, Abstract Co-Author: Nothing to Disclose

Jun Zhang PhD, Abstract Co-Author: Nothing to Disclose

Michael Vinzenz Knopp MD, PhD, Abstract Co-Author: Nothing to Disclose

Nathan C. Hall MD, PhD, Abstract Co-Author: Consultant, Enlyton, Ltd

To prospectively assess the temporal changes of multi-imaging parameters from MRI and PET/CT, including ADC, tumor size, and standardized uptake value (SUV) for early therapy monitoring in cervix cancer patients.

Ten cervical cancer patients with stage IB2-IVA underwent: 4 multi-parametric 1.5 T MRI (pre-, early-, mid-and post-therapy) and 3 PET/CT using 18F-fluorodeoxyglucose (FDG), (pre-, early-, and mid-therapy). A total dose of 4500 cGy was given with external beam radiation therapy, as well as concurrent weekly chemotherapy with Cisplatin (25-40 mg/m2). 3-dimentional tumor region of interest were identified using MIM software. ADC map values and T2W based tumor size were calculated using MIPAV software for the four sequential MRIs. Max SUV body weight (bw) was calculated using MIM software for the 3 sequential PET/CT scans.

Multi-parametric MRI showed gradual reduction in tumor size and an increase in the ADC values while PET/CT SUV decreased from pre-therapy to mid-therapy; the mean values of these parameters are : pre-therapy ADC 0.0010 ± 0.0002 mm2/s, tumor size 47.8±34.6 cm3 and max SUVbw 15.8±5.4, early-therapy ADC 0.0011±0.0002 mm2/s, tumor size 34.4±24.3 cm3 and max SUVbw 11±5.1, mid-therapy ADC 0.0012 ±0.0002 mm2/s, tumor size 15.4± 15.5 cm3 and max SUVbw 7±2.3, and post-therapy ADC 0.0012±0.0002 mm2/s and tumor size 6.9±3.8 cm3. A negative correlation between pre-therapy ADC & max SUV was found (r =-0.56). A tumor size reduction rate from pre-therapy to post-therapy is negatively correlated to ADC increase rate (r =-0.73).

 Imaging parameters from the MR and PET/CT, standard modality for the assessment of treatment response in cervical cancer, correlate significantly and our limited data suggest both modalities are efficacious during early treatment. Our research establishes an opportunity to further investigate the comparative effectiveness of each parameter at different treatment time points and further augment the potentials of these parameters for the early responsiveness assessment and long-term outcome prediction.

Current research paves the foundation for cost-effective analysis of the presumed “expensive” MR and PET/CT and potential augmentation efficacy from the combined-modality approach.

Elias, S, Jia, G, Mayr, N, Yuh, W, Zhang, J, Knopp, M, Hall, N, Temporal Changes of Imaging Parameters of MRI and FDG-PET/CT during Treatment in Cervix Cancer.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13014023.html