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Clinical Article
The value of multimodal MRI combined with clinical indexes in predicting the short-term effect of neoadjuvant therapy for stage ⅠB1-ⅡA2 cervical cancer
MA Jintao  QIN Fengying  ZHAO Mingli  PANG Huiting  LUO Yahong  DONG Yue 

Cite this article as: Ma JT, Qin FY, Zhao ML, et al. The value of multimodal MRI combined with clinical indexes in predicting the short-term effect of neoadjuvant therapy for stage ⅠB1-ⅡA2 cervical cancer[J]. Chin J Magn Reson Imaging, 2022, 13(1): 59-63, 102. DOI:10.12015/issn.1674-8034.2022.01.012.

[Abstract] Objective To access the value of multimodal MRI combined with clinical indexes to predict the efficacy of neoadjuvant therapy for stage ⅠB1-ⅡA2 cervical cancer.Materials and Methods Sixty-four cases of cervical cancer patient who received neoadjuvant therapy were retrospectively analyzed. According to the treatment response, the patients were divided into significant response group and non-significant response group. The clinical indexes, ADC value and DCE-MRI parameters (Ktrans, Kep, Ve) of the two groups were analyzed and compared. The correlation between clinical and imaging indexes of the two groups and the neoadjuvant therapy effect was analyzed to establish a reliable model for predicting treatment effect.Results Univariate analysis showed that there was no significant difference in age, tumor diameter, clinical stage [International Federation of Gynecology and Obstetrics (FIGO) 2009], squamous carcinoma antigen, pathological type. and neoadjuvant therapy methods between the two groups (P=0.092, 0.500, 0.299, 1.000, 0.101, 0.092), and there was no significant difference in ADC and Ve values between the two groups before treatment (P=0.830, 0.891, 0.853, 0.883, 0.859, 0.170, 0.159, 0.637, 0.404, 0.934). Ktrans and Kep before treatment in the significant response group were higher than those in the non-significant response group (P=0.001, 0.037). Multivariate analysis showed that the predictive model constructed by age, pathological type and the 50th percentile of Kep had the highest diagnostic efficiency, with an AUC of 0.891 (0.812, 0.971), a specificity of 86.3% and a sensitivity of 91.3%.Conclusions MRI parameters combined with clinical indexes have a certain value in predicting short-term efficacy of neoadjuvant therapy for cervical cancer.
[Keywords] cervical cancer;neoadjuvant therapy;curative effect;dynamic contrast enhanced magnetic resonance imaging;diffusion-weighted imaging

MA Jintao   QIN Fengying   ZHAO Mingli   PANG Huiting   LUO Yahong   DONG Yue*  

Department of Radiology, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical University, Dalian Medical University Clinical Oncology College, Shenyang 110041, China

Dong Y, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Climbing Foundation of National Cancer Center, China (No. NCC201806B011); Medical engineering cross fund of Liaoning Cancer Hospital and Dalian University of technology, China (No. LD202119); The Fundamental Research Funds for the Central Universities.
Received  2021-05-28
Accepted  2021-11-09
DOI: 10.12015/issn.1674-8034.2022.01.012
Cite this article as: Ma JT, Qin FY, Zhao ML, et al. The value of multimodal MRI combined with clinical indexes in predicting the short-term effect of neoadjuvant therapy for stage ⅠB1-ⅡA2 cervical cancer[J]. Chin J Magn Reson Imaging, 2022, 13(1): 59-63, 102. DOI:10.12015/issn.1674-8034.2022.01.012.

Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. DOI: 10.3322/caac.21492.
Leath CA, Monk BJ. Twenty-first century cervical cancer management: A historical perspective of the gynecologic oncology group/NRG oncology over the past twenty years[J]. Gynecol Oncol, 2018, 150(3): 391-397. DOI: 10.1016/j.ygyno.2018.06.023.
Motton S, Houvenaeghel G, Delannes M, et al. Results of surgery after concurrent chemoradiotherapy in advanced cervical cancer: comparison of extended hysterectomy and extrafascial hysterectomy[J]. Int J Gynecol Cancer, 2010, 20(2): 268-275. DOI: 10.1111/igc.0b013e3181c9e385.
Touboul C, Uzan C, Mauguen A, et al. Prognostic factors and morbidities after completion surgery in patients undergoing initial chemoradiation therapy for locally advanced cervical cancer[J]. Oncologist, 2010, 15(4): 405-415. DOI: 10.1634/theoncologist.2009-0295.
Ma YM, Zhao GL, Qi J, et al. Neoadjuvant brachytherapy and chemotherapy followed by radical surgery for stage IB2 and IIA cervical cancer: A retrospective comparison with chemoirradiation[J]. Mol Clin Oncol, 2018, 8(4): 617-622. DOI: 10.3892/mco.2018.1580.
Feng Y, Liu H, Ding Y, et al. Combined dynamic DCE-MRI and diffusion-weighted imaging to evaluate the effect of neoadjuvant chemotherapy in cervical cancer[J]. Tumori, 2020, 106(2): 155-164. DOI: 10.1177/0300891619886656.
Zhang A, Song J, MA Z, et al. Combined dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging to predict neoadjuvant chemotherapy effect in FIGO stage ⅠB2-ⅡA2 cervical cancers[J]. Radiol Med, 2020, DOI: 10.1007/s11547-020-01214-x.
Tian X, Sun C, Liu Z, et al. Prediction of Response to Preoperative Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer Using Multicenter CT-Based Radiomic Analysis[J]. Front Oncol, 2020, 10(77). DOI: 10.3389/fonc.2020.00077.
Hu T, Li S, Chen Y, et al. Matched-case comparison of neoadjuvant chemotherapy in patients with FIGO stage ⅠB1-ⅡB cervical cancer to establish selection criteria[J]. Eur J Cancer, 2012, 48(15): 2353-2360. DOI: 10.1016/j.ejca.2012.03.015.
Yang Z, Chen D, Zhang J, et al. The efficacy and safety of neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer: A randomized multicenter study[J]. Gynecologic Oncology, 2016, 141(2): 231-239. DOI: 10.1016/j.ygyno.2015.06.027.
Dang Y, Liu Q, Long LX, et al. The Effect of Neoadjuvant Chemotherapy Combined With Brachytherapy Before Radical Hysterectomy on Stage ⅠB2 and ⅡA Cervical Cancer: A Retrospective Analysis[J]. Front Oncol, 2021, 11: 618612. DOI: 10.3389/fonc.2021.618612.
Xu Y, Zhang M, Zhang J, et al. Neoadjuvant chemotherapy increases the 5-year overall survival of patients with resectable cervical cancer: A systematic review and meta-analysis[J]. Taiwan J Obstet Gynecol, 2021, 60(3): 433-441. DOI: 10.1016/j.tjog.2021.03.008.
Zhang Y, Li B, Wang Y, et al. Paclitaxel Plus Platinum Neoadjuvant Chemotherapy Followed by Surgery Versus Primary Surgery in Locally Advanced Cervical Cancer-A Propensity Score Matching Analysis[J]. Front Oncol, 2020, 10: 604308. DOI: 10.3389/fonc.2020.604308.
Kong SY, Huang K, Zeng C, et al. The association between short-term response and long-term survival for cervical cancer patients undergoing neoadjuvant chemotherapy: a system review and meta-analysis[J]. Sci Rep, 2018, 8(1): 1545. DOI: 10.1038/s41598-018-19948-0.
Zhou J, Li X, Huang K, et al. Young Cervical Cancer Patients May Be More Responsive than Older Patients to Neoadjuvant Chemotherapy Followed by Radical Surgery[J]. PLoS One, 2016, 11(2): e0149534. DOI: 10.1371/journal.pone.0149534.
Ciolina M, Vinci V, Villani L, et al. Texture analysis versus conventional MRI prognostic factors in predicting tumor response to neoadjuvant chemotherapy in patients with locally advanced cancer of the uterine cervix[J]. Radiol Med, 2019, 124(10): 955-964. DOI: 10.1007/s11547-019-01055-3.
Yokoi E, Mabuchi S, Takahashi R, et al. Impact of histological subtype on survival in patients with locally advanced cervical cancer that were treated with definitive radiotherapy: adenocarcinoma/adenosquamous carcinoma versus squamous cell carcinoma[J]. J Gynecol Oncol, 2017, 28(2): e19. DOI: 10.3802/jgo.2017.28.e19.
Fu C, Bian D, Liu F, et al. The value of diffusion-weighted magnetic resonance imaging in assessing the response of locally advanced cervical cancer to neoadjuvant chemotherapy[J]. Int J Gynecol Cancer, 2012, 22(6): 1037-1043. DOI: 10.1097/IGC.0b013e31825736d7.
Himoto Y, Fujimoto K, Kido A, et al. Assessment of the early predictive power of quantitative magnetic resonance imaging parameters during neoadjuvant chemotherapy for uterine cervical cancer[J]. Int J Gynecol Cancer, 2014, 24(4): 751-757. DOI: 10.1097/IGC.0000000000000124.
Viallard C, Larrivée B. Tumor angiogenesis and vascular normalization: alternative therapeutic targets[J]. Angiogenesis, 2017, 20(4): 409-426. DOI: 10.1007/s10456-017-9562-9.
Hill RP, Bristow RG, Fyles A, et al. Hypoxia and Predicting Radiation Response[J]. Semin Radiat Oncol, 2015, 25(4): 260-272. DOI: 10.1016/j.semradonc.2015.05.004.

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