Wagenaar H C, Trimbos J B, Postema S, Anastasopoulou A, van der Geest R J, Reiber J H, Kenter G G, Peters A A, Pattynama P M
Department of Gynecology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.
Gynecol Oncol. 2001 Sep;82(3):474-82. doi: 10.1006/gyno.2001.6267.
The aim of this study was to evaluate the predictive value of pretherapeutic magnetic resonance imaging (MRI)-based measurements of tumor diameter and volume with regard to recurrent disease.
MRI on 0.5- or 1.5-T scanners was performed in 126 consecutive women with invasive carcinoma of the uterine cervix. Initial tumor diameter and volume were determined on T(2)-weighted images; volume was calculated by the standard technique of multiplying the sum of the areas by the slice thickness. Patients were treated by radical surgery, radiotherapy, or a combined approach based on clinical International Federation of Gynecology and Obstetrics (FIGO) stage and individual patient criteria. Clinical data (patient age and FIGO stage), MRI-derived tumor dimensions (diameter and volume), and histological findings (tumor invasion depth and lymph-node involvement) were associated and linked to patient outcome.
MRI-based tumor diameter correlated strongly with histological tumor invasion depth and lymph-node status (P < 0.01 and P = 0.01) while tumor volume on MRI was significantly associated only with tumor invasion depth into adjacent tissues (P < 0.01). Univariate analysis demonstrated graphically that MRI-derived tumor diameter and volume and clinical FIGO stage are associated with progression-free survival. Correlation analysis showed a strong association between MRI-derived tumor diameter and volume on MRI (r = 68%, P < 0.01) and also demonstrated a correlation between tumor diameter on MRI and FIGO stage Ib (Ib1 versus Ib2) cervical tumors (r = 46.7%, P < 0.01).
Tumor diameter and volume, determined by pretreatment MRI examinations, predict progression-free survival for patients with invasive cervical carcinoma. This study demonstrates the value of MRI as an adjunct to clinical evaluation of invasive cervical cancer, providing more complete assessment of morphological risk factors important in patient prognosis and treatment planning.
本研究旨在评估基于治疗前磁共振成像（MRI）测量的肿瘤直径和体积对复发性疾病的预测价值。
对126例连续的子宫颈浸润癌女性患者进行了0.5或1.5 T扫描仪的MRI检查。在T2加权图像上确定初始肿瘤直径和体积；体积通过将各层面面积总和乘以层面厚度的标准技术计算得出。患者根据临床国际妇产科联盟（FIGO）分期和个体患者标准接受根治性手术、放疗或联合治疗。将临床数据（患者年龄和FIGO分期）、MRI得出的肿瘤尺寸（直径和体积）以及组织学结果（肿瘤浸润深度和淋巴结受累情况）进行关联，并与患者的预后相关联。
基于MRI的肿瘤直径与组织学肿瘤浸润深度和淋巴结状态密切相关（P<0.01和P = 0.01），而MRI上的肿瘤体积仅与肿瘤向相邻组织的浸润深度显著相关（P<0.01）。单因素分析直观显示，MRI得出的肿瘤直径和体积以及临床FIGO分期与无进展生存期相关。相关性分析显示，MRI得出的肿瘤直径与MRI上的肿瘤体积之间存在强相关性（r = 68%，P<0.01），并且还显示MRI上的肿瘤直径与FIGO Ib期（Ib1与Ib2）宫颈肿瘤之间存在相关性（r = 46.7%，P<0.01）。
通过治疗前MRI检查确定的肿瘤直径和体积可预测子宫颈浸润癌患者的无进展生存期。本研究证明了MRI作为子宫颈浸润癌临床评估辅助手段的价值，能更全面地评估对患者预后和治疗规划重要的形态学危险因素。
