Novel imaging techniques as response biomarkers in cervical cancer

Value of apparent diffusion coefficient (ADC) in assessing radiotherapy and chemotherapy success in cervical cancer

“…On the other hand, tumors at various stages exhibit increasingly complex architecture, with densely packed cells, altered membrane permeability and highly restricted extracellular space, all of which impede water mobility. Importantly, ADC value, a quantitative parameter in DWI that measures the rate of water mobility, increases after successful therapy because tumor cell density decreases, resulting in removal of barriers to water motion [16,17]. In clinic, ADC values are vital for planning therapy, in identification of tumor boundaries and in deciding eligibility for surgical resection [18].…”

The SUVmax (maximum standardized uptake value for F-18 fluorodeoxyglucose) and serum squamous cell carcinoma antigen (SCC-ag) function as prognostic biomarkers in patients with primary cervical cancer

“…Although LN assessment is not part of the FIGO clinical staging, it is generally performed during the initial workup of patients with cervical cancer as an important component of treatment planning, since the survival rates for patients with nodal metastases are significantly lower than those without nodal metastases (Chung et al 2010a;Ishikawa et al 1999;Lai et al 1999;Sakuragi et al 1999;Waggoner 2003;Haie-Meder et al 2010;Kidd et al 2010a). Other clinical and pathological risk factors including age, histological tumor type, stage, pelvic lymph node (PLN) metastasis, involvement of the resection margin and the parametrium (PM), deep cervical stromal invasion, bulky tumor size, and lymphovascular space invasion (LVSI) have also been identified as predictive of treatment outcome (Chung et al 2010b;Harry 2010;Kashimura et al 1990;Werner-Wasik et al 1995;Perez et al 1992Perez et al , 1998.…”

Added Value of Perfusion in Gynaecological Imaging

“…It is believed that if persistent enhancement is present at the site of the cervical tumor or the surgical bed, residual disease is likely with high risk of recurrence and poor prognosis and adjunctive therapy should be advised [5,9,41]. In a small study conducted by Boss et al [5,42] done on patients after radiotherapy, early enhancement at the original site of the tumor (<6 seconds) was associated with poor prognosis and denoted recurrence, whereas delayed enhancement (>6 seconds) was associated with good prognosis and was the result of post-radiotherapy fibrosis.…”

“…The early predictability of tumor response after therapy provides a golden opportunity to quickly change failed treatment regimens, limiting the related side effects and high costs and instituting these regimens with more successful ones [5,9]. Dynamic contrast enhanced MRI (DCE-MRI) is performed by acquisition of multiple sequential images before, during and after the passage of contrast material through a specific area of interest [8].…”