Magnetic resonance imaging in cervical cancer: A basis for objective classification

Burghardt, E; Hofmann, H.G.; Ebner, F.; Haas, Josef; Tamussino, Karl; Justich, E

doi:10.1016/0020-7292(89)90421-9

Cited by 18 publications

(35 citation statements)

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“…Tumor volume is a very important predictive factor in terms of local control and therefore a complete coverage of the gross tumor volume (GTV) and the related clinical target volume (CTV) is crucial and a prerequisite for the treatment outcome. The awareness of the importance of treatment planning and target volume assessment has increased substantially during the last decade (8)(9)(10)(11)(12). The most appropriate imaging technique is probably magnetic resonance imaging (MRI) to define tumor size, configuration and infiltration of the surrounding tissues (13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: Predictive factors for local tumor control and early recurrences

Sorbe¹

2009

Int J Oncol

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Abstract. In a series of 131 primary cervical carcinomas in FIGO stages I-IV suitable for combined external pelvic and intraluminal cervical-vaginal brachytherapy predictive and prognostic factors were analyzed with regard to locoregional tumor control, recurrences and survival data. Patients with prior surgery or patients treated with external beam therapy alone were excluded from this series. Concomitant chemotherapy was given to 47 patients (36%). The external beam therapy was given with a four-field technique (50-60 Gy) and brachytherapy with high dose-rate (Ir-192) using a ring applicator set. The dose (18-30 Gy) was specified according to the rules in ICRU 38 (a minimum dose to the surface of the target volume). Three or five fractions were given once a week in parallel with external beam irradiation. A CT-based 3-D dose-planning system (TMS) was used for the external beam therapy and for the brachytherapy planning (PLATO). The mean age of the patients was 65 years. One hundred and seven tumors were squamous cell carcinomas (82%) and 24 adenocarcinomas or adenosquamous carcinomas. One hundred and eight tumors were in FIGO stages I-II and 23 tumors in stages III-IV. The mean tumor diameter was 44 mm. Most tumors (92%) were moderately well or poorly differentiated. The primary cure rate of the complete series was 92% and 98% after chemoradiotherapy. Squamous cell carcinomas had complete remission in 96% and adenocarcinomas in 81% (Pearson Chi-square; P=0.00002). Tumor size was also highly significantly associated with local tumor control. The brachytherapy dose, the combined external and brachytherapy dose and the number of days of interruption (delay) of external irradiation were all significant predictive factors of local tumor control. In the complete series 39 recurrences (30%) were recorded. A lower FIGO stage, chemoradiotherapy, squamous cell histology, diploid DNA-profile, a higher brachytherapy dose, more brachytherapy fractions and a higher total combined irradiation dose were favorable factors with regard to the risk of tumor recurrences. The overall survival rate was 50% and the cancer-specific survival rate 65%. Tumor size was the strongest individual prognostic factor in multivariate analysis. Chemoradiotherapy therapy versus radiotherapy alone and squamous cell carcinomas versus adenocarcinomas were associated with improved survival rates. Early radiation reactions were recorded in 58% (mostly grade 1) and serious late radiation reactions (grade 3-4) in 11%.

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Section: Introductionmentioning

confidence: 99%

Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: Predictive factors for local tumor control and early recurrences

Sorbe¹

2009

Int J Oncol

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“…This is a challenge in the imaging of unrespectable cervical cancer and in many other unrespectable cancers. But a European study by Burghardt et al [15] reported that the volumes obtained by MRI correlated well (r = 0.983) with those obtained by histomorphometric analysis of the surgical specimens in cervical cancer (stage I and IIB tumors, which are treated surgically in Europe).…”

Section: Discussionmentioning

confidence: 97%

“…Clinical palpation is also a subjective method and has significant interobserver variability [26][27][28]. More recent studies have shown that the three-dimensional quantitative imaging-based method of tumor size measurement using MRI is highly accurate in determining actual tumor size and extent to surrounding tissue [2,3,15,16,[29][30][31][32][33][34][35][36][37]. MRI has been recognized as an important imaging modality for the management of cervical cancer because of its multiplanar capability and distinct tissue contrast, particularly between tumor and surrounding normal tissue [9].…”

Section: Discussionmentioning

confidence: 99%

“…However, the ideal method for the accurate measurement of primary tumor volume remains controversial [9,10,21]. A 3D ROI-based tumor volumetry has been documented as the most accurate noninvasive tumor volume measurement in cervical cancer based on a classic surgical correlation study of 3D ROI imaging measurements with 3D ROI measurement of histologic giant tissue sections of the pathologic specimens [9,15]. But imaging-based tumor volume assessment, the tumor volume by diameter-based method have been traditionally estimated and reported to be equivalent to the more complex 3D ROI volumetry that delineates the entire tumor region three dimensionally [23,33,39].…”

Section: Discussionmentioning

confidence: 99%

“…With the advent of magnetic resonance imaging (MRI), it has become possible to estimate the size of the primary tumor more accurately than was prior possible by clinical palpation or computer tomography (CT) in inoperable patient [15][16][17]. Tumor size and local invasion in the surgical specimen correlates well with www.e-roj.org http://dx.doi.org/10.3857/roj.2012.…”

Section: Introductionmentioning

confidence: 99%

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Method of Tumor Volume Evaluation using Magnetic Resonance Imaging for Outcome Prediction in Cervical Cancer Treated with Concurrent Chemotherapy and Radiotherapy

Kim

2008

International Journal of Radiation Oncology*Biology*Physics

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A thin‐walled polydimethylsiloxane bioreactor for high‐density hepatocyte sandwich culture

Tan

Toh

Birgersson

et al. 2013

Biotech & Bioengineering

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In vitro drug testing requires long-term maintenance of hepatocyte liver specific functions. Hepatocytes cultured at a higher seeding density in a sandwich configuration exhibit an increased level of liver specific functions when compared to low density cultures due to the better cell to cell contacts that promote long term maintenance of polarity and liver specific functions. However, culturing hepatocytes at high seeding densities in a standard 24-well plate poses problems in terms of the mass transport of nutrients and oxygen to the cells. In view of this drawback, we have developed a polydimethylsiloxane (PDMS) bioreactor that was able to maintain the long-term liver specific functions of a hepatocyte sandwich culture at a high seeding density. The bioreactor was fabricated with PDMS, an oxygen permeable material, which allowed direct oxygenation and perfusion to take place simultaneously. The mass transport of oxygen and the level of shear stress acting on the cells were analyzed by computational fluid dynamics (CFD). The combination of both direct oxygenation and perfusion has a synergistic effect on the liver specific function of a high density hepatocyte sandwich culture over a period of 9 days.

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Magnetic resonance imaging in cervical cancer: A basis for objective classification

Cited by 18 publications

References 0 publications

Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: Predictive factors for local tumor control and early recurrences

Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: Predictive factors for local tumor control and early recurrences

Method of Tumor Volume Evaluation using Magnetic Resonance Imaging for Outcome Prediction in Cervical Cancer Treated with Concurrent Chemotherapy and Radiotherapy

A thin‐walled polydimethylsiloxane bioreactor for high‐density hepatocyte sandwich culture

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