Julia R. Fielding MD, Presenter: Nothing to Disclose

Amir H. Khandani MD, Abstract Co-Author: Nothing to Disclose

Tiffany Matoska Sills MD, PhD, Abstract Co-Author: Nothing to Disclose

Ellen Louise Jones MD, PhD, Abstract Co-Author: Nothing to Disclose

Paola Gehrig, Abstract Co-Author: Nothing to Disclose

Pinakpani Roy MD, Abstract Co-Author: Nothing to Disclose

Weili Lin PhD, Abstract Co-Author: Nothing to Disclose

To determine whether PET/MR correlates with response to treatment in women with advanced cervical cancer.

In this prospective pilot study, simultaneous acquisition of PET/MR images of the pelvis pre- and post-initial treatment were obtained on 5 women with cervical cancer, clinical stage >1B. This study was IRB and HIPAA compliant. Contrast agents included gadobenate dimeglumine and FDG. The MR protocol consisted of high resolution T2WI, 3D pre- and post- contrast T1-weighted and diffusion series. Simultaneously, a single station PET acquisition was obtained. MR images and PET images of the primary tumor were assessed by 2 different physicians. Decreased tumor size and enhancement of the treated tumor on MR images and decreased SUV on PET images were considered to indicate response to therapy. These results were compared with clinical response to radiation therapy or surgery.

4 patients underwent external beam radiation therapy and 1 underwent surgery. Pre-treatment exams demonstrated maximum tumor size of 1.7, 1.7, 4.7, 4.8 and 8.7cm. SUV were 12.8, 4.1, 4.9, 8.1 and 25.2, respectively. On MR imaging 2 patients had parametrial extension and 2 patients had lymph nodes larger than 1cm. Increased size and SUV correlated well with a high grade tumor biopsy and clinical stage. On post- therapy images no residual tumor was identified in the surgical patient on MR or PET images. Tumor size decreased as did SUV in all patients after undergoing external beam therapy. (See attached table)

In this pilot study both PET and MR imaging response correlated with clinical staging. Assessment of 20 patients following primary and secondary stages of radiation therapy or surgery is ongoing.

Combined functional and anatomic imaging may become surrogates for or confirm clinical staging of advanced cervical cancer.

Fielding, J, Khandani, A, Sills, T, Jones, E, Gehrig, P, Roy, P, Lin, W, PET/MR of Cervical Cancer: Correlation with Baseline and Post Treatment Clinical Staging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002921.html