Volume computed tomography perfusion as a predictive marker for treatment response to concurrent chemoradiotherapy in cervical cancer: a prospective study

Acta Radiol. 2021 Feb;62(2):281-288. doi: 10.1177/0284185120919261. Epub 2020 Jun 17.

Abstract

Background: Computed tomography perfusion (CTP) can provide information on blood perfusion as a reliable marker of tumor response to therapy.

Purpose: To assess the role of volume CTP (vCTP) parameters in predicting treatment response to concurrent chemoradiotherapy (CCRT) for cervical cancer.

Material and methods: Thirty-three patients with cervical cancer underwent vCTP. Three CTP parameters of cervical cancer-including arterial flow (AF), blood volume (BV), and permeability surface (PS)-were measured in two different ways: the region of interest incorporating the "local hot" with the highest enhancement and "cold spot" with the lowest enhancement; and "whole-tumor" measurements. The patients were divided into non-residual and residual tumor groups according to the short-term response to treatment. The clinical and perfusion parameters were compared between the two groups.

Results: There was no significant difference in age, body mass index, FIGO stage, pathological grade, or pretreatment tumor size between the two groups (P > 0.05). The non-residual tumor group had higher pretreatment AF in high-perfusion and low-perfusion subregions than the residual tumor group (P <0.05), but the AF in whole-tumor regions was not different between the two groups (P > 0.05). There were no differences in BV and PS between the two groups (P > 0.05). The diagnostic potency of AF in the low-perfusion subregion was higher than that in the high-perfusion subregion.

Conclusion: vCTP parameters are valuable for the prediction of short-term effects. The AF in the low-perfusion subregion was a more effective index for predicting treatment response to CCRT of cervical cancer.

Keywords: Volume computed tomography perfusion; arterial flow; cervical cancer; concurrent chemoradiotherapy.

MeSH terms

  • Adult
  • Aged
  • Cervix Uteri / diagnostic imaging
  • Cervix Uteri / drug effects
  • Cervix Uteri / radiation effects
  • Chemoradiotherapy / methods*
  • Cone-Beam Computed Tomography / methods*
  • Female
  • Humans
  • Middle Aged
  • Perfusion Imaging
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome
  • Uterine Cervical Neoplasms / diagnostic imaging*
  • Uterine Cervical Neoplasms / therapy*