Jungmin Bae, Presenter: Nothing to Disclose

Chan Kyo Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Seung Hee Choi, Abstract Co-Author: Nothing to Disclose

Sung Yoon Park, Abstract Co-Author: Nothing to Disclose

Byung Kwan Park MD, Abstract Co-Author: Nothing to Disclose

To investigate the feasibility of blood oxygenation level-dependent (BOLD) MR imaging (MRI) in assessing early changes to concurrent chemoradiotherapy (CCRT) in patients with cervical cancer.

This prospective study was approved by our institutional review board. 15 consecutive patients with biopsy-proven cervical cancer who treated with CCRT were evaluated with MRI at 3T, including BOLD MRI. Three serial MR examinations were performed before CCRT (preTx); after 1 week of therapy (postT1); and after 4 weeks after therapy (postT2). BOLD MRI was performed using a multiple fast field echo (mFFE) sequence with 8, 12, 16 and 20 gradient echoes. At each time, the rate of spin dephasing (R2*) values at 4 different gradient echoes were measured in the tumor and normal uterus using manufacturer-supplied software (PRIDE Relaxation Maps Tool, version 2.1.1, philips Healthcare), and the results were compared. For reproducibility of R2* measurements, 8 patients had two separate pretreatment MRI at an interval of < 1 week. Repeated measures analysis of variance with a Bonferroni correction and Altman-Bland test were used for statistical analyses.

The mean R2* values of the tumors from preTx to postT2 tended to have consecutive increase at 8 echoes (20.7, 22.4 and 34.1), 12 echoes (20.9, 22.7 and 32.1), 16 echoes (21.3, 22.5 and 34.1) and 20 echoes (20.9, 22.8 and 33.3); however, compared with preTx, postT2 showed a significant increase in R2* values (P < 0.001), while postT1 had no significant difference (P> 0.05). At each time, the mean R2* values of the normal uterus were not significantly different at 4 different gradient echoes (P> 0.05). At 4 different gradient echoes, the reproducibility of R2* measurements in the tumor and normal uterus was confirmed with a mean difference of 0.1%–2.8% and 0.2%–7.6%, respectively.

BOLD MRI is a feasible, reproducible technique and may demonstrate early physiologic changes to CCRT in patients with cervical cancer.

As a noninvasive, reproducible biomarker, BOLD MRI can be used to evaluate early therapeutic response to CCRT in patients with cervical cancer.

Bae, J, Kim, C, Choi, S, Park, S, Park, B, Blood Oxygenation Level-Dependent MR Imaging: Early Changes to Concurrent Chemoradiotherapy in Cervical Cancer.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13018987.html