The potential of contemporary diagnostic imaging modalities for improving assessment of treatment response in patients with locally advanced cervical cancer

Klimenko E.V., Khalimon A.I., Rubtsova N.A., Leont’ev A.V., Mukhtarulina S.V., Mal’tsagova KH.R., Rerberg A.G., Novikova E.G., Kaprin A.D.

P. Hertsen Moscow Oncology Research Institute - branch of the National Medical Radiology Research Centre of Minzdrav of Russia, Moscow, Russia
Aim. To investigate the potential of CT perfusion in assessing treatment response in patients with locally advanced cervical cancer undergoing selective chemotherapy in comparison with 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT).
Material and methods. The study included 15 patients with stages IB1 — IIIB cervical cancer, according to FIGO. All patients underwent pelvic ultrasonography and magnetic resonance imaging (MRI), CT perfusion of the uterine cervix, and whole-body 18F-FDG PET-CT at the initial stage and after first-line therapy including 2 courses of regional chemotherapy.
Results. Analysis of PET/CT scan results showed that the local complete and partial metabolic response was achieved in 1 (6.7%) and 10 (66.7%) patients, respectively, and 4 (26.6%) patients had stabilization. Spread to extra-pelvic sites (the lungs) occurred in 1 (6.7%) patient, in whom the local progression was defined as stabilization. Dynamic changes in all perfusion parameters, except for BF, were more pronounced in patients with the complete and partial metabolic response. The difference in indicators such as BV and MTT was significantly different in all study groups (with an increase in parallel with the completeness of the metabolic response), while the difference in PS in the groups of complete and partial metabolic response did not differ significantly, but was significantly larger than in the metabolic stabilization group.
Conclusion. Perfusion indicators of BV and MTT, before and after treatment, are the most informative in assessing treatment response to selective chemotherapy for locally advanced cervical cancer. There was a correlation between the changes in perfusion indicators such as BV, PS, MTT, and SUVmax in all groups, in comparison with the metabolic response determined by PET/CT.

Keywords

CT perfusion
PET-CT
cervical cancer
neoadjuvant chemotherapy
assessment of treatment response

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Received 26.12.2019

Accepted 09.01.2020

About the Authors

Elena V. Klimenko, radiologist of the radiology Department of the Moscow state medical Institute. P. A. Herzen-branch of the Federal state budgetary institution NMIC
of radiology of the Ministry of health of Russia. E-mail: elenasherbahina@mail.ru ; Phone: +7(985)279-85-45.
125284, Russia, Moscow, 2nd Botkin passage, 3.
Aleksandr I. Halimon, radiologist of the radiology Department of the Moscow state medical Institute. P. A. Herzen-branch of the Federal state budgetary institution NMIC
of radiology of the Ministry of health of Russia.
125284, Russia, Moscow, 2nd Botkin passage, 3.
Natalya A. Rubtsova, MD, head of the Department of radiology, radiologist mnioi them. P. A. Herzen-branch of the Federal state budgetary institution NMIC of radiology
of the Ministry of health of Russia.
125284, Russia, Moscow, 2nd Botkin passage, 3.
Aleksey V. Leontiev, head of the Department of radionuclide diagnostics, radiologist of the Moscow state research Institute. P.A. Herzen-branch of the Federal state budgetary institution NMIC of radiology of the Ministry of health of Russia. 125284, Russia, Moscow, 2nd Botkin passage, 3.
Svetlana V., Mukhtarulina, MD, head of the Department of oncogynecology, oncologist of the Moscow state medical Institute. P. A. Herzen-branch of the Federal state budgetary institution NMIC of radiology of the Ministry of health of Russia.
125284, Russia, Moscow, 2nd Botkin passage, 3.
Kheda R. Maltsagova, oncologist of the Department of oncogynecology of the Moscow state medical Institute. P. A. Herzen-branch of the Federal state budgetary institution NMIC of radiology of the Ministry of health of Russia.
125284, Russia, Moscow, 2nd Botkin passage, 3.
Andrey G. Rerberg, PhD, head of the day hospital, doctor for x-ray endovascular diagnosis and treatment of MNIOI. P. A. Herzen-branch of the Federal state budgetary institution NMIC of radiology of the Ministry of health of Russia.
125284, Russia, Moscow, 2nd Botkin passage, 3.
Elena G. Novikova, MD, professor, Honored worker of science of the Russian Federation, oncologist, head of the Department of oncogynecology
of MNIOI. P. A. Herzen-branch of the Federal state budgetary institution NMIC of radiology of the Ministry of health of Russia.
125284, Russia, Moscow, 2nd Botkin passage, 3.
Andrey D. Kaprin, MD, professor, academician of the Russian Academy of Sciences, Director of MNIOI im. P.A. Herzen – branch FGBU SMRC radiology of Ministry
of health of Russia. Tel.: +7(495)9455939
125284, Russia, Moscow, 2nd Botkin passage, 3.

For citation: Klimenko E.V., Khalimon A.I., Rubtsova N.A., Leont’ev A.V., Mukhtarulina S.V., Mal’tsagova Kh.R., Rerberg A.G., Novikova E.G., Kaprin A.D. The potential of contemporary diagnostic imaging modalities for improving assessment of treatment response in patients with locally advanced cervical cancer.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 1(Suppl): 34-43(in Russian)
https://dx.doi.org/10.18565/aig.2020.1suppl.34-43

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