Lund Kjersti V, Simonsen Trude G, Kristensen Gunnar B, Rofstad Einar K
a Department of Radiation Biology , Institute for Cancer Research, Norwegian Radium Hospital , Oslo , Norway.
b Department of Radiology and Nuclear Medicine , Oslo University Hospital , Oslo , Norway.
Acta Oncol. 2017 May;56(5):675-681. doi: 10.1080/0284186X.2017.1294762. Epub 2017 Feb 28.
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may provide prognostic biomarkers for cervix carcinoma. We have shown previously that the early phase of the signal intensity-versus-time curve (SITC) may have significant prognostic power. The purpose of the present investigation was to explore the prognostic value of the late phase of the SITC.
DCE-MRI data of 80 patients (FIGO stage IB-IVA) treated with concurrent chemoradiotherapy were examined. Four parameters were calculated from the late-phase SITC: tumor volume with decreasing signal, tumor fraction with decreasing signal, tumor volume with increasing signal (TVIS), and tumor fraction with increasing signal.
Multivariate analysis involving clinical parameters and late-phase SITC parameters suggested that TVIS is a strong independent prognostic factor for both disease-free and overall survival. When early-phase SITC parameters were included in the multivariate analysis, the early-phase SITC, but not the late-phase SITC, was found to have independent prognostic value.
The late-phase SITC can provide prognostic factors for the outcome of cervix carcinoma, that is, a large tumor volume with increasing late-phase SITCs is associated with poor outcome. However, the prognostic power of the late-phase SITC is not as strong as that of the early-phase SITC.
动态对比增强磁共振成像（DCE-MRI）可为宫颈癌提供预后生物标志物。我们之前已经表明，信号强度-时间曲线（SITC）的早期阶段可能具有显著的预后价值。本研究的目的是探讨SITC晚期阶段的预后价值。
对80例接受同步放化疗的患者（国际妇产科联盟（FIGO）分期为IB-IVA期）的DCE-MRI数据进行了检查。从SITC晚期阶段计算出四个参数：信号降低的肿瘤体积、信号降低的肿瘤比例、信号增加的肿瘤体积（TVIS）以及信号增加的肿瘤比例。
涉及临床参数和SITC晚期阶段参数的多因素分析表明，TVIS是无病生存期和总生存期的一个强大的独立预后因素。当将SITC早期阶段参数纳入多因素分析时，发现SITC早期阶段而非晚期阶段具有独立预后价值。
SITC晚期阶段可为宫颈癌的预后提供因素，即晚期SITC信号增加且肿瘤体积较大与预后不良相关。然而，SITC晚期阶段的预后能力不如早期阶段强。
