Shih I-Lun, Yen Rouh-Fang, Chen Chi-An, Cheng Wen-Fang, Chen Bang-Bin, Chang Yu-Hsuan, Cheng Mei-Fang, Shih Tiffany Ting-Fang
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Department of Radiology, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Magn Reson Imaging. 2021 Jan;53(1):305-318. doi: 10.1002/jmri.27311. Epub 2020 Aug 14.
Positron emission tomography (PET)/MRI biomarkers have been shown to have prognostic significance in patients with cervical cancer. Their associations with progression-free survival (PFS) and overall survival (OS) merit further investigation.
To evaluate the association between PET/MRI biomarkers and tumor stage, PFS, and OS in patients with cervical cancer.
Prospective cohort study.
In all, 54 patients with newly diagnosed cervical cancer and measurable tumors (>1 cm) were included in the image analysis.
FIELD STRENGTH/SEQUENCE: 3.0T integrated PET/MRI including diffusion-weighted echo-planar imaging (b = 50 and 1000 s/mm ) and [18F]fluorodeoxyglucose PET.
Two radiologists measured the minimum and mean apparent diffusion coefficient (ADC and ADC ), maximum standardized uptake value (SUV ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors.
A Mann-Whitney U-test was used to evaluate the association between the imaging biomarkers and tumor stage. A Cox proportional hazards model was used to assess the relationships between the imaging biomarkers and survival.
In advanced tumors (T ≥ 1b2, M1, stage ≥ IB3), ADC was significantly lower and MTV, TLG, MTV/ADC , and TLG/ADC were significantly higher (P values between <0.001 and 0.036). In N1 tumors, ADC was significantly lower and MTV and MTV/ADC were significantly higher (P values between 0.005 and 0.016). In survival analysis, SUV was an independent predictor of PFS (hazard ratio [HR] = 4.57, P < 0.05), and ADC was an independent predictor of OS (HR = 0.02, P < 0.05). In subgroup analysis of patients with different stages, MTV/ADC was a predictor of PFS in stage I disease (P = 0.003), ADC (P = 0.038), and MTV (P = 0.020) in stage II, SUV (P = 0.006), and TLG (P = 0.006) in stage IV; and ADC was a predictor of OS in stage III disease (P = 0.008).
PET/MRI biomarkers of cervical cancer are associated with tumor stage and survival. SUV and ADC are independent predictors of PFS and OS, respectively.
1 TECHNICAL EFFICACY: 3.
正电子发射断层扫描（PET）/磁共振成像（MRI）生物标志物已被证明在宫颈癌患者中具有预后意义。它们与无进展生存期（PFS）和总生存期（OS）的关联值得进一步研究。
评估PET/MRI生物标志物与宫颈癌患者肿瘤分期、PFS和OS之间的关联。
前瞻性队列研究。
共有54例新诊断的宫颈癌且肿瘤可测量（>1 cm）的患者纳入图像分析。
场强/序列：3.0T一体化PET/MRI，包括扩散加权回波平面成像（b = 50和1000 s/mm²）以及[¹⁸F]氟代脱氧葡萄糖PET。
两名放射科医生测量了原发性肿瘤的最小和平均表观扩散系数（ADCmin和ADCmean）、最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）。
采用曼-惠特尼U检验评估成像生物标志物与肿瘤分期之间的关联。采用Cox比例风险模型评估成像生物标志物与生存之间的关系。
在晚期肿瘤（T≥1b2、M1、分期≥IB3）中，ADCmin显著降低，MTV、TLG、MTV/ADCmin和TLG/ADCmin显著升高（P值在<0.001至0.036之间）。在N1期肿瘤中，ADCmin显著降低，MTV和MTV/ADCmin显著升高（P值在0.005至0.016之间）。在生存分析中，SUVmax是PFS的独立预测因子（风险比[HR]=4.57，P<0.05），ADCmin是OS的独立预测因子（HR = 0.02，P<0.05）。在不同分期患者的亚组分析中，MTV/ADCmin是I期疾病PFS的预测因子（P = 0.003），II期的ADCmin（P = 0.038）和MTV（P = 0.020），IV期的SUVmax（P = 0.006）和TLG（P = 0.006）；ADCmin是III期疾病OS的预测因子（P = 0.008）。
宫颈癌的PET/MRI生物标志物与肿瘤分期和生存相关。SUVmax和ADCmin分别是PFS和OS的独立预测因子。
1 技术效能：3。
