Complementary prognostic value of pelvic magnetic resonance imaging and whole-body fluorodeoxyglucose positron emission tomography/computed tomography in the pretreatment assessment of patients with cervical cancer Journal Article


Authors: Sala, E.; Micco, M.; Burger, I. A.; Yakar, D.; Kollmeier, M. A.; Goldman, D. A.; Gonen, M.; Park, K. J.; Abu-Rustum, N. R.; Hricak, H.; Vargas, H. A.
Article Title: Complementary prognostic value of pelvic magnetic resonance imaging and whole-body fluorodeoxyglucose positron emission tomography/computed tomography in the pretreatment assessment of patients with cervical cancer
Abstract: Objective The aim of this study was to evaluate the incremental prognostic value of pelvic magnetic resonance imaging (MRI) and whole-body 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) findings compared with clinical-histopathologic factors in patients with newly diagnosed cervical cancer. Methods The institutional review board approved this retrospective study of 114 patients (median age, 40.6 years) with International Federation of Gynecology and Obstetrics (FIGO) stage I-IVB cervical cancer who underwent pretreatment MRI and PET/CT. All scans were reviewed for locoregional tumor extent, pelvic or/and para-aortic lymphadenopathy, and distant metastases. Univariate Cox proportional hazard regression was performed to evaluate associations between clinical-histopathologic factors, imaging findings, and progression-free survival (PFS). Multivariate models were built using independent predictors for PFS. Harrell C was used to measure concordance (C index). Results Forty patients progressed within a median time of 10.4 months (range, 0.4-40.3 months). At univariate analysis, age, FIGO stage, tumor histology, tumor grade, and all MRI and PET/CT features were significantly associated with PFS (P < 0.0001 to P = 0.0474). A multivariate model including clinical and imaging parameters (parametrial invasion on MRI and para-aortic lymphadenopathy/distant metastases on PET/CT) had significantly higher concordance for predicting PFS than a model including clinical parameters only (C index: 0.81 [95% confidence interval, 0.75-0.87] vs 0.68 [95% confidence interval, 0.59-0.78]; P < 0.001). The comparison of C indices for the combined clinical and imaging model approached significance when compared with a FIGO stage model (C index: 0.81 [95% confidence interval, 0.75-0.87] vs 0.75 [95% confidence interval, 0.69-0.82]; P = 0.058). Conclusions In patients with newly diagnosed cervical cancer, a prognostic model including combined MRI and PET/CT findings provides information that complements clinical and histopathologic factors. © 2015 by IGCS and ESGO.
Keywords: adult; cancer chemotherapy; aged; cancer surgery; major clinical study; multimodality cancer therapy; conference paper; cancer radiotherapy; nuclear magnetic resonance imaging; follow up; antineoplastic agent; progression free survival; retrospective study; distant metastasis; electronic medical record; uterine cervix cancer; fluorodeoxyglucose f 18; computer assisted emission tomography; lymphadenopathy; chemoradiotherapy; cervical cancer; whole body pet; nuclear magnetic resonance scanner; prognostic value; cancer prognosis; human; female; priority journal; pelvic mri; whole-body fdg pet/ct
Journal Title: International Journal of Gynecological Cancer
Volume: 25
Issue: 8
ISSN: 1048-891X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2015-10-01
Start Page: 1461
End Page: 1467
Language: English
DOI: 10.1097/igc.0000000000000519
PROVIDER: scopus
PUBMED: 26397068
PMCID: PMC4998040
DOI/URL:
Notes: Export Date: 2 November 2015 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Evis Sala
    94 Sala
  2. Mithat Gonen
    701 Gonen
  3. Marisa A Kollmeier
    144 Kollmeier
  4. Kay Jung Park
    181 Park
  5. Hedvig Hricak
    330 Hricak
  6. Debra Alyssa Goldman
    92 Goldman
  7. Irene Andrea Burger
    10 Burger
  8. Maura Micco
    10 Micco
  9. Derya   Yakar
    4 Yakar