DCE-MRI Quantitative Parameters as Predictors of Treatment Response in Patients With Locally Advanced Cervical Squamous Cell Carcinoma Underwent CCRT

Bing Liu; Zhen Sun; Wan-Ling Ma; Jing Ren; Guang-Wen Zhang; Meng-Qi Wei; Wei-Huan Hou; Bing-Xin Hou; Li-Chun Wei; Yi Huan; Min-Wen Zheng

doi:10.3389/fonc.2020.585738

DCE-MRI Quantitative Parameters as Predictors of Treatment Response in Patients With Locally Advanced Cervical Squamous Cell Carcinoma Underwent CCRT

Front Oncol. 2020 Oct 29:10:585738. doi: 10.3389/fonc.2020.585738. eCollection 2020.

Authors

Bing Liu¹, Zhen Sun², Wan-Ling Ma³, Jing Ren¹, Guang-Wen Zhang¹, Meng-Qi Wei¹, Wei-Huan Hou¹, Bing-Xin Hou⁴, Li-Chun Wei⁴, Yi Huan¹, Min-Wen Zheng¹

Affiliations

¹ Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
² Department of Orthopedic, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
³ Department of Radiology, Longgang District People's Hospital, Shenzhen, China.
⁴ Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

Abstract

Purpose: To evaluate the predictive value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters in treatment response to concurrent chemoradiotherapy (CCRT) for locally advanced cervical squamous cell carcinoma (LACSC).

Methods and materials: LACSC patients underwent CCRT had DCE-MRI before (e0) and after 3 days of treatment (e3). Extended Tofts Linear model with a user arterial input function was adopted to generate quantitative measurements. Endothelial transfer constant (K^trans), reflux rate (K_ep), fractional extravascular extracellular space volume (V_e), and fractional plasma volume (V_p) were calculated, and percentage changes ΔK^trans, ΔK_ep, ΔV_e, and ΔV_p were computed. The correlations of these measurements with the tumor regression rate were analyzed. The predictive value of these parameters on treatment outcome was generated by the receiver operating characteristic (ROC) curve. Univariate and multivariate logistic regression analyses were conducted to find the independent variables.

Results: K^trans-e0, K_ep -e0, ΔK^trans, and ΔV_e were positively correlated with the tumor regression rate. Mean values of K^trans-e0, K^trans-e3, ΔK^trans, and ΔV_e were higher in the non-residual tumor group than residual tumor group and were independent prognostic factors for predicting residual tumor occurrence. K^trans-e3 showed the highest area under the curve (AUC) for treatment response prediction.

Conclusions: Quantitative parameters at e0 and e3 from DCE-MRI could be used as potential indicators for predicting treatment response of LACSC.

Keywords: Tofts DCE-MRI model; cervical cancer; concurrent chemoradiotherapy; dynamic contrast-enhanced magnetic resonance imaging; treatment response.