Post-radiotherapy contrast enhancement changes in fast dynamic MRI of cervical carcinoma.
until further notice
SourceJournal of Magnetic Resonance Imaging, 13, 4, (2001), pp. 600-606
Article / Letter to editor
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Journal of Magnetic Resonance Imaging
SubjectBiomedical Magnetic Resonance; Experimental radiotherapy and neuro-oncology.; Prevention of disorders in human reproduction: (Patho)Physiological, endocrinological and methabolic aspects; Biomedische Magnetische Resonantie; Experimentele radiotherapie en neuro-oncologie.; Preventie van stoornissen in de menselijke voortplanting: (Patho-)fysiologische, endocriene en metabole aspecten.
This pilot study determines fast dynamic gadolinium enhanced MRI contrast enhancement parameters (onset of enhancement and time to peak enhancement) before and after radiotherapy in 10 cervical carcinoma patients. Before radiotherapy, onset of enhancement and time to peak enhancement were early, with a median of 4.5 and 5.2 seconds, respectively. High-grade tumors showed early enhancement, compared with low-grade. After radiotherapy, contrast enhancement patterns differed. In survivors, onset of enhancement after radiotherapy was later than before radiotherapy. In non-survivors, onset of enhancement after radiotherapy was still early. The median difference in onset of enhancement before and after radiotherapy in survivors and non-survivors was an increase of 3.2 and a decrease of 1.1 seconds, respectively. Early onset of enhancement after radiotherapy was a better predictor for survival than a high-signal intensity zone on post radiotherapy unenhanced T1/T2-weighted MRI. It is concluded that enhancement parameters from fast dynamic Gd-enhanced MR images can provide additional functional information with regard to tumor vascularization, and may have prognostic significance. It complements clinical examination and unenhanced MRI in determining the effectiveness of radiotherapy treatment in cervical carcinoma. Future studies will focus on the clinical utility and improvements of the estimation of contrast-enhanced parameters with this new technique.
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