Prediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix.

2.50
Hdl Handle:
http://hdl.handle.net/10541/80236
Title:
Prediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix.
Authors:
Loncaster, Juliette A; Carrington, Bernadette M; Sykes, Jonathan R; Jones, Andrew P; Todd, Susan M; Cooper, Rachel A; Buckley, David L; Davidson, Susan E; Logue, John P; Hunter, Robin D; West, Catharine M L
Abstract:
PURPOSE: To investigate whether analysis of MRI enhancement data using a pharmacokinetic model improved a previously found correlation between contrast enhancement and tumor oxygenation measured using PO2 histograph. To evaluate the prognostic value of gadolinium enhancement data for radiotherapy outcome, and to study the efficacy of combined enhancement and MRI volume data. METHODS AND MATERIALS: Fifty patients underwent dynamic gadolinium-enhanced MRI as part of their initial staging investigations before treatment. Gadolinium enhancement was analyzed using the Brix pharmacokinetic model to obtain the parameters amplitude and rate of contrast enhancement. Pretreatment tumor oxygen measurements (Eppendorf PO2 histograph) were available for 35 patients. RESULTS: Both standard and pharmacokinetic-derived enhancement data correlated with tumor oxygenation measurements, and poorly enhancing tumors had low tumor oxygen levels. However, only the pharmacokinetic-analyzed data correlated with patient outcome and patients with poorly (amplitude less than median) vs. well-enhancing tumors had significantly worse disease-specific survival (p = 0.024). For the 50 patients studied, no relationship was found between enhancement and volume data. Combining MRI volume and enhancement information highlighted large differences in outcome (p = 0.0054). At the time of analysis, only 55% of patients with large, poorly enhanced tumors were alive compared with 92% of patients with small, well-enhanced tumors. CONCLUSION: These preliminary results suggest that pharmacokinetic modeling of dynamic contrast-enhanced MRI provides data that reflect tumor oxygenation and yields useful prognostic information in patients with locally advanced carcinoma of the cervix. Combining MRI-derived enhancement and volume data delineates large differences in radiotherapy outcome.
Affiliation:
Academic Department of Radiation Oncology, Christie Hospital NHS Trust, Manchester, UK.
Citation:
Prediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix. 2002, 54 (3):759-67 Int. J. Radiat. Oncol. Biol. Phys.
Journal:
International Journal of Radiation Oncology, Biology, Physics
Issue Date:
1-Nov-2002
URI:
http://hdl.handle.net/10541/80236
PubMed ID:
12377328
Type:
Article
Language:
en
ISSN:
0360-3016
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorLoncaster, Juliette A-
dc.contributor.authorCarrington, Bernadette M-
dc.contributor.authorSykes, Jonathan R-
dc.contributor.authorJones, Andrew P-
dc.contributor.authorTodd, Susan M-
dc.contributor.authorCooper, Rachel A-
dc.contributor.authorBuckley, David L-
dc.contributor.authorDavidson, Susan E-
dc.contributor.authorLogue, John P-
dc.contributor.authorHunter, Robin D-
dc.contributor.authorWest, Catharine M L-
dc.date.accessioned2009-09-08T10:17:10Z-
dc.date.available2009-09-08T10:17:10Z-
dc.date.issued2002-11-01-
dc.identifier.citationPrediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix. 2002, 54 (3):759-67 Int. J. Radiat. Oncol. Biol. Phys.en
dc.identifier.issn0360-3016-
dc.identifier.pmid12377328-
dc.identifier.urihttp://hdl.handle.net/10541/80236-
dc.description.abstractPURPOSE: To investigate whether analysis of MRI enhancement data using a pharmacokinetic model improved a previously found correlation between contrast enhancement and tumor oxygenation measured using PO2 histograph. To evaluate the prognostic value of gadolinium enhancement data for radiotherapy outcome, and to study the efficacy of combined enhancement and MRI volume data. METHODS AND MATERIALS: Fifty patients underwent dynamic gadolinium-enhanced MRI as part of their initial staging investigations before treatment. Gadolinium enhancement was analyzed using the Brix pharmacokinetic model to obtain the parameters amplitude and rate of contrast enhancement. Pretreatment tumor oxygen measurements (Eppendorf PO2 histograph) were available for 35 patients. RESULTS: Both standard and pharmacokinetic-derived enhancement data correlated with tumor oxygenation measurements, and poorly enhancing tumors had low tumor oxygen levels. However, only the pharmacokinetic-analyzed data correlated with patient outcome and patients with poorly (amplitude less than median) vs. well-enhancing tumors had significantly worse disease-specific survival (p = 0.024). For the 50 patients studied, no relationship was found between enhancement and volume data. Combining MRI volume and enhancement information highlighted large differences in outcome (p = 0.0054). At the time of analysis, only 55% of patients with large, poorly enhanced tumors were alive compared with 92% of patients with small, well-enhanced tumors. CONCLUSION: These preliminary results suggest that pharmacokinetic modeling of dynamic contrast-enhanced MRI provides data that reflect tumor oxygenation and yields useful prognostic information in patients with locally advanced carcinoma of the cervix. Combining MRI-derived enhancement and volume data delineates large differences in radiotherapy outcome.en
dc.language.isoenen
dc.subjectUterine Cervical Canceren
dc.subject.meshAdenocarcinoma-
dc.subject.meshAnalysis of Variance-
dc.subject.meshCarcinoma, Adenosquamous-
dc.subject.meshCell Hypoxia-
dc.subject.meshFemale-
dc.subject.meshGadolinium-
dc.subject.meshHumans-
dc.subject.meshMagnetic Resonance Imaging-
dc.subject.meshMiddle Aged-
dc.subject.meshOxygen-
dc.subject.meshRadioisotopes-
dc.subject.meshTreatment Outcome-
dc.subject.meshUterine Cervical Neoplasms-
dc.titlePrediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix.en
dc.typeArticleen
dc.contributor.departmentAcademic Department of Radiation Oncology, Christie Hospital NHS Trust, Manchester, UK.en
dc.identifier.journalInternational Journal of Radiation Oncology, Biology, Physicsen

Related articles on PubMed

All Items in Christie are protected by copyright, with all rights reserved, unless otherwise indicated.