Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Advanced Cervical Carcinoma The Advantage of Perfusion Parameters From the Peripheral Region in Predicting the Early Response to Radiotherapy

Objective: This study aimed to investigate the importance of perfusion parameters from the peripheral region in predicting the early response to radiotherapy for advanced cervical carcinoma by using dynamic contrast-enhanced (DCE) perfusion magnetic resonance imaging (MRI). Methods: One hundred eight patients with advanced cervical carcinoma were enrolled into this study. Dynamic contrast-enhanced perfusion MR examinations were performed for all the patients before radiotherapy. Perfusion parameters were obtained from the central region and the peripheral region of tumor respectively. After radiotherapy, the patients were classified into responders and nonresponders according to tumor shrinkage on the basis of follow-up MRI examination. The mean follow-up time lasted 12 months. The perfusion parameters were compared between the 2 groups. The relationship between perfusion parameters from 2 different regions of tumor and treatment effect was analyzed. Results: The mean value of volume transfer constant (K-trans), rate constant (Kep) or extravascular extracellular volume fraction (Ve) from the peripheral region was higher than that from the central region of tumor, respectively (P = 0.01, 004, 0.03). Responders had higher K-peripheral(trans) (K(trans )from the peripheral region) and K-central(trans) (K(trans )from the central region) values than nonresponders (P = 0.04, 0.01). Responders had higher Kep(peripheral) (Kep from the peripheral region) than nonresponders (P = 0.03). Responders had lower Ve(peripheral) (Ve from the peripheral region) than nonresponders (P = 0.04). At logistic regression analysis, the perfusion parameters that had predicting value were K-peripheral(trans), Ve(peripheral), KeP(peripheral) and K-central(trans) according to diagnostic potency. Conclusions: Compared with perfusion parameters from the central region of tumor, perfusion parameters from the peripheral region are more valuable in predicting the early response to radiotherapy for advanced cervical carcinoma.