Role of 3T multiparametric-MRI with BOLD hypoxia imaging for diagnosis and post therapy response evaluation of postoperative recurrent cervical cancers

Mahajan, Abhishek; Engineer, Reena; Chopra, Supriya; Mahanshetty, Umesh; Juvekar, Sashikant; Shrivastava, SK; Desekar, Naresh; Thakur, Meenakshi

doi:10.1016/j.ejro.2015.11.003

Cited by 36 publications

(20 citation statements)

References 31 publications

(43 reference statements)

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“…In difficult cases, functional imaging, including DWI and DCE, can be a useful addition. Mahajan et al [ 99 ] examined 30 patients after hysterectomy with suspected local tumour recurrence. Additional multiparametric sequences, including DWI and DCE, increased the diagnostic accuracy to 100% compared to 70% accuracy with conventional MRI alone.…”

Section: Tumour Recurrence and Therapeutic Responsementioning

confidence: 99%

The value of advanced MRI techniques in the assessment of cervical cancer: a review

et al. 2017

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ObjectivesTo assess the value of new magnetic resonance imaging (MRI) techniques in cervical cancer.MethodsWe searched PubMed and MEDLINE and reviewed articles published from 1990 to 2016 to identify studies that used MRI techniques, such as diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and dynamic contrast enhancement (DCE) MRI, to assess parametric invasion, to detect lymph node metastases, tumour subtype and grading, and to detect and predict tumour recurrence.ResultsSeventy-nine studies were included. The additional use of DWI improved the accuracy and sensitivity of the evaluation of parametrial extension. Most studies reported improved detection of nodal metastases. Functional MRI techniques have the potential to assess tumour subtypes and tumour grade differentiation, and they showed additional value in detecting and predicting treatment response. Limitations included a lack of technical standardisation, which limits reproducibility.ConclusionsNew advanced MRI techniques allow improved analysis of tumour biology and the tumour microenvironment. They can improve TNM staging and show promise for tumour classification and for assessing the risk of tumour recurrence. They may be helpful for developing optimised and personalised therapy for patients with cervical cancer.Teaching points • Conventional MRI plays a key role in the evaluation of cervical cancer. • DWI improves tumour delineation and detection of nodal metastases in cervical cancer. • Advanced MRI techniques show promise regarding histological grading and subtype differentiation. • Tumour ADC is a potential biomarker for response to treatment.

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Section: Tumour Recurrence and Therapeutic Responsementioning

confidence: 99%

The value of advanced MRI techniques in the assessment of cervical cancer: a review

et al. 2017

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“…As a leading cause of mortality in women, cervical cancer still exhibits unclear molecular mechanisms [ 4 ]. Despite of the significant advances including surgical techniques, radiotherapy and chemotherapy, there are still nearly 30 % of patients diagnosed with invasive cervical carcinoma that passes away due to residual or recurrent disease [ 11 ]. However, increasing evidence indicates that the expression or overexpression of UHRF1 is associated with a poor prognosis in a variety of cancer types [ 7 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

UHRF1 gene silencing inhibits cell proliferation and promotes cell apoptosis in human cervical squamous cell carcinoma CaSki cells

Yang

Chen

et al. 2016

J Ovarian Res

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BackgroundUp-regulation of UHRF1 has been observed in a variety of cancers and appears to serve as an independent prognostic factor.ObjectiveTo explore the effect of UHRF1 gene silencing on apoptosis and proliferation of cervical squamous cell carcinoma (CSCC) CaSki cells.MethodsThis study consisted of 47 CSCC tissues and 40 normal cervical tissues. The CaSki cells were assigned into Blank group (CaSki cells not transfected), NC group (CaSki cells transfected with control siRNA), and UHRF1 Silence group (CaSki cells transfected with UHRF1 siRNA). qRT-PCR and Western blot were used for UHRF1 mRNA and protein expressions, CKK-8 assay for cell proliferation, flow cytometry for cell cycle and apoptosis, Western blot for expressions of apoptosis-related proteins. Nude mice tumor transplant experiment was performed.ResultsUHRF1 exhibited higher mRNA and protein expressions in the CSCC tissues than normal cervical tissues (both P < 0.05). The cell proliferation ability in the UHRF1 Silence group was reduced when compared with the Blank group and the NC group, the cells at S-G2M stage in the UHRF1 Silence group were dropped when compared with the Blank group and the NC group (P < 0.05), while the cells at G0/G1 stage were elevated (P < 0.05), and the proportion of Annexin V positive cells in the UHRF1 Silence group was increased in comparison with the Blank group and the NC group (P < 0.05). Nude mice tumor transplant experiment indicated that the growth rate and weight of tumor in the Blank group and NC group was higher and heavier than the UHRF1 Silence group (P < 0.05).ConclusionUHRF1 showed a high expression in CSCC and UHRF1 silencing can reduce proliferation and enhance apoptosis of the CaSki cells.

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“…This was further supported by a study on 65 patients [ 82 ], showing that non-responders had significantly higher R2* compared to responders. Moreover, in 30 patients with recurrent disease after surgery, hypoxic fraction derived from R2* mapping at the time of second line radiotherapy was significantly correlated with percentage of tumor shrinkage [ 83 ]. Thus, the body of literature on BOLD and related techniques in cervical cancer is more extensive and includes more patients than the literature on hypoxia PET tracers.…”

Section: Bold—blood Oxygenation Level-dependent Mri and Related Technmentioning

confidence: 99%

Hypoxia in cervical cancer: from biology to imaging

Lyng

Malinen

2017

Clin Transl Imaging

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PurposeHypoxia imaging may improve identification of cervical cancer patients at risk of treatment failure and be utilized in treatment planning and monitoring, but its clinical potential is far from fully realized. Here, we briefly describe the biology of hypoxia in cervix tumors of relevance for imaging, and evaluate positron emission tomography (PET) and magnetic resonance imaging (MRI) techniques that have shown promise for assessing hypoxia in a clinical setting. We further discuss emerging imaging approaches, and how imaging can play a role in future treatment strategies to target hypoxia.MethodsWe performed a PubMed literature search, using keywords related to imaging and hypoxia in cervical cancer, with a particular emphasis on studies correlating imaging with other hypoxia measures and treatment outcome.ResultsOnly a few and rather small studies have utilized PET with tracers specific for hypoxia, and no firm conclusions regarding preferred tracer or clinical potential can be drawn so far. Most studies address indirect hypoxia imaging with dynamic contrast-enhanced techniques. Strong evidences for a role of these techniques in hypoxia imaging have been presented. Pre-treatment images have shown significant association to outcome in several studies, and images acquired during fractionated radiotherapy may further improve risk stratification. Multiparametric MRI and multimodality PET/MRI enable combined imaging of factors of relevance for tumor hypoxia and warrant further investigation.ConclusionsSeveral imaging approaches have shown promise for hypoxia imaging in cervical cancer. Evaluation in large clinical trials is required to decide upon the optimal modality and approach.

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Role of 3T multiparametric-MRI with BOLD hypoxia imaging for diagnosis and post therapy response evaluation of postoperative recurrent cervical cancers

Cited by 36 publications

References 31 publications

The value of advanced MRI techniques in the assessment of cervical cancer: a review

The value of advanced MRI techniques in the assessment of cervical cancer: a review

UHRF1 gene silencing inhibits cell proliferation and promotes cell apoptosis in human cervical squamous cell carcinoma CaSki cells

Hypoxia in cervical cancer: from biology to imaging

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