Dynamic contrast-enhanced 3-T MR imaging in cervical cancer before and after concurrent chemoradiotherapy.

Objective: To investigate the changes of dynamic contrast-enhanced MR imaging (DCE-MRI) parameters at 3 T in cervical cancer patients before and after concurrent chemoradiotherapy (CCRT), and to correlate the parameters with final tumour response to therapy.

Methods: Thirty-five patients with cervical cancer underwent DCE-MRI before CCRT, 4 weeks after starting therapy and at 1 month after the end of therapy. DCE-MRI parameters were calculated in the tumour and normal gluteus muscle. Final response to treatment as determined by changes in tumour size and volume was correlated with pre-treatment DCE-MRI parameters.

Results: DCE-MRI parameters (i.e. K (trans), v (e) and k (ep)) in the tumours showed significant changes in response to CCRT (P < 0.05) and in particular K (trans) and v (e) demonstrated early significant increase (P < 0.01), but those in normal muscle did not show a significant difference (P > 0.05). Before therapy, the mean values of K (trans), k (ep), v (e) and v (p) in the tumours were significantly greater than those in muscle (P < 0.05). DCE-MRI parameters of the tumours at pre-treatment were not statistically associated with final tumour size or volume change.

Conclusion: DCE-MRI parameters may help evaluate early changes of cervical cancer to CCRT, but larger, more definitive studies are needed.

Key Points: • DCE-MRI offers new insights into tumour behaviour. • Changes in tumour size lag behind biomarkers which improve quickly in responders. • DCE-MRI is a non-invasive imaging technique that can characterize tumour vasculature. • DCE-MRI of cervical cancer may be useful in monitoring changes with therapy.