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Basic T1 Perfusion Magnetic Resonance Imaging Evaluation of the Therapeutic Effect of Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer

Fu, Chun MD*; Feng, Xiaoyan MS*; Bian, Dujun MD; Du, Wanping BS; Wang, Xiangquan MS*; Zhao, Yan MS*

International Journal of Gynecological Cancer: September 2013 - Volume 23 - Issue 7 - p 1270–1278
doi: 10.1097/IGC.0b013e31829db950
Cervical Cancer

Objective: The objective of this study was to evaluate the dynamic changes of blood perfusion coinciding with tumor regression after neoadjuvant chemotherapy (NACT) in locally advanced cervical cancer (LACC).

Methods: Thirty patients with LACC received conventional 3.0-T magnetic resonance imaging and perfusion-weighted imaging scans at 3 different times (before NACT, 2 weeks after the first NACT, and 2 weeks after the second NACT). Characteristics of time-intensity diagrams and patterns of blood perfusion maps according to the parameter of area under the curve (AUC) were observed. Eight perfusion parameters were compared among 3 time points at 2 different chemotherapy-sensitive groups by the software of Basic T1 Perfusion.

Results: The effective chemotherapy rate was 73.3% (22/30). The characteristic of time-intensity diagrams in cervical cancer was a rapid onset with plateau. There were 3 patterns of AUC perfusion maps. The common perfusion map was rich blood supply type in the effective chemotherapy group and peripheral blood supply type in the ineffective chemotherapy group. Four parameter values (relative enhancement, maximum enhancement, wash-in rate, and AUC) were significantly reduced 2 weeks after the second NACT than those before the therapy (P = 0.000; P = 0.009; P = 0.011; and P = 0.000) in the effective chemotherapy group, especially the value of relative enhancement 2 weeks after the first NACT, was obviously decreased compared to that before the therapy (P = 0.042). The value of time to peak 2 weeks after the second NACT was significantly longer than that before the therapy in the effective chemotherapy group (P = 0.001). There were no obvious changes of blood perfusion parameters among the 3 different times in the ineffective chemotherapy group.

Conclusions: Tumor blood perfusion has obviously decreased after effective NACT in the treatment of LACC.

Departments of *Gynecology and Obstetrics and †Radiology, Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China.

Address correspondence and reprint requests to Chun Fu, MD, Department of Gynecology and Obstetrics, Second Xiangya Hospital, Central South University, 139 Middle Renmin Rd, Changsha, Hunan 410011, People’s Republic of China. E-mail: 923074121@qq.com.

This work was supported by National Science Foundation of Hunan Province of the People’s Republic of China (10JJ6044), Hunan Science and Technology Department Project of the People’s Republic of China (2009SK3161, 2011FJ3008), and Scientific Research Foundation of Hunan Provincial Health Bureau of the People’s Republic of China (B2009022).

The authors declare no conflicts of interest.

Received December 2, 2012

Accepted May 27, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.