Flückiger F, Ebner F, Poschauko H, Arian-Schad K, Einspieler R, Hausegger K
Universitätsklinik für Radiologie, Karl-Franzens-Universität, Graz, Osterreich.
Strahlenther Onkol. 1991 Mar;167(3):152-7.
This study investigates the reliability of magnet resonance imaging in the evaluation of response to therapy and in follow-up after primary irradiation (RTX) of uterine cervical carcinomas in 25 patients (follow-up eleven to 39 months). Most of the tumors showed six months after RTX a significant reduction of volume and signal intensity in T2 weighted images. 20/25 (80%) showed a total tumor regression, 5/25 (20%) had a residual tumor (all of them had a primary tumor volume higher than 50 ccm). Four patients got a recurrent tumor in follow-up. Residual and recurrent tumors showed like the primary in heavily T2 weighted images significant higher signal intensity than fibrosis. Therefore posttreatment fibrosis is distinguishable from residual or recurrent neoplasm. Early radiation fibrosis (less than 6 months after RTX) showed higher signal intensity than fibrosis in later stages. This fact may be the cause of false positive results in searching for residual tumor within the first six months after RTX. Our results indicate that magnet resonance imaging is a reliable method to evaluate tumor response after radiation treatment and to detect recurrent neoplasm. The results of a greater patient population over a longer period of follow-up will be presented in future.
本研究调查了磁共振成像在评估25例子宫颈癌患者接受初次放射治疗（RTX）后的治疗反应及随访中的可靠性（随访时间为11至39个月）。大多数肿瘤在RTX后6个月时，T2加权图像上显示体积和信号强度显著降低。25例中有20例（80%）肿瘤完全消退，5例（20%）有残留肿瘤（所有残留肿瘤患者的原发肿瘤体积均高于50立方厘米）。4例患者在随访中出现肿瘤复发。残留肿瘤和复发性肿瘤在T2加权像上，与原发肿瘤一样，信号强度显著高于纤维化。因此，治疗后纤维化可与残留或复发性肿瘤区分开来。早期放射性纤维化（RTX后不到6个月）的信号强度高于后期纤维化。这一事实可能是RTX后前6个月内寻找残留肿瘤时出现假阳性结果的原因。我们的结果表明，磁共振成像是评估放射治疗后肿瘤反应和检测复发性肿瘤的可靠方法。未来将展示更大患者群体更长随访期的结果。
