Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Eur Radiol. 2020 Jan;30(1):471-481. doi: 10.1007/s00330-019-06345-y. Epub 2019 Jul 29.
To explore the value of strain elastography as an early predictor of long-term prognosis in patients with locally advanced cervical cancers treated with concurrent chemoradiotherapy (CCRT).
Strain elastography examinations were performed on 45 patients with locally advanced cervical cancers at 3 time points: prior to CCRT, and at 1 and 2 weeks after the start of CCRT. The maximum tumor diameter (D), strain ratio (SR), and their percentage changes (ΔD and ΔSR) were calculated to predict long-term prognosis. Based on the results of physical examinations, Papanicolaou test, and pelvic magnetic resonance imaging, we classified patients into two groups: responders (complete remission) and non-responders (sustained disease, recurrence, or death).
After a median follow-up of 30 months (range, 12-36 months), 36 of 45 (80%) patients were disease free. The D as well as ΔD at 2 weeks during CCRT was able to predict the responder outcomes, with an area-under-the-curve (AUC) of 0.733 and 0.731, respectively. Furthermore, significant differences in SR and ΔSR at 1 and 2 weeks during therapy were shown between the responder and non-responder groups (all p < 0.05), and ΔSR at 2 weeks during CCRT presented with the highest AUC (0.91), yielding 88.9% sensitivity and 88.9% specificity with a selected cutoff value.
Strain elastography may be useful as an early predictor of long-term outcomes after CCRT for patients with cervical cancer.
• The D as well as ΔD at 2 weeks during CCRT can predict the responder outcomes. • The elastography parameters (SR and ΔSR) exhibited predictive values of favorable response after therapy initiation. • ΔSR at 2 weeks during CCRT held the best predictive value for the responder outcomes.
探讨应变弹性成像作为同步放化疗（CCRT）治疗局部晚期宫颈癌患者长期预后的早期预测指标的价值。
对 45 例局部晚期宫颈癌患者在 3 个时间点进行应变弹性成像检查：CCRT 前、CCRT 开始后 1 周和 2 周。计算最大肿瘤直径（D）、应变比（SR）及其百分比变化（ΔD 和 ΔSR），以预测长期预后。根据体格检查、巴氏涂片检查和盆腔磁共振成像的结果，将患者分为两组：应答者（完全缓解）和非应答者（持续疾病、复发或死亡）。
中位随访 30 个月（范围 12-36 个月）后，45 例患者中有 36 例（80%）无疾病。CCRT 期间 2 周的 D 以及 ΔD 可预测应答者的结果，曲线下面积（AUC）分别为 0.733 和 0.731。此外，治疗期间 1 周和 2 周的 SR 和 ΔSR 差异在应答者和非应答者之间有统计学意义（均 p<0.05），并且 CCRT 期间 2 周的 ΔSR 具有最高的 AUC（0.91），选择最佳截断值时具有 88.9%的敏感性和 88.9%的特异性。
应变弹性成像可能是预测宫颈癌患者 CCRT 后长期结局的有用指标。
CCRT 期间 2 周的 D 以及 ΔD 可预测应答者的结果。
治疗开始时的弹性成像参数（SR 和 ΔSR）具有良好的应答预测值。
CCRT 期间 2 周的 ΔSR 对应答者的结果具有最佳的预测价值。
