Tumor volume measured by 3-D magnetic resonance imaging in the prediction of prognosis for cervical carcinoma

Kim, Young Tae; Kim, Sang Wun; Nam, Eun Ji; Kim, Sung Hoon; Kim, Jae Hoon; Kim, Jae Wook; Youn, Joung Sub; Yoon, Bo Sung

Abstract

OBJECTIVE
Clinical evaluation of tumor size in cervical cancer is often difficult. Digital imaging technique using computer has shown an eye opening progress. Quantitative analysis of tumor size or tumor volume using magnetic resonance imaging (MRI) has been reported as useful in the prediction of prognosis in patients with cervical cancer. The purpose of this study was to evaluate whether quantitative analysis can further improve the efficacy of using MR imaging to predict the prognosis of cervical cancer.
METHODS
MRI on 0.5- or 1.5-T scanners was performed in 93 consecutive women with invasive carcinoma of the uterine cervix. Initial tumor diameter and volume were determined on T2-weighted images; volume was calculated by the standard technique of multiplying the sum of the areas by the slice thickness. Patients were treated by radical surgery, radiotherapy, or a concurrent chemoradiotherapy based on clinical International Federation of Gynecology and Obstetrics (FIGO) stage and individual patient criteria. Clinical data (patient age and FIGO stage), MRI-derived tumor dimensions (diameter and volume), and histological findings (tumor invasion depth and histological type) were associated and linked to patient outcome.
RESULTS
Tumor volume on MRI was significantly associated with recurrence of cervical cancer (P=0.018). Univariate analysis demonstrated graphically that MRI-derived tumor volume and clinical stage were associated with progression-free survival.
CONCLUSION
Our preliminary results suggest that tumor volume, determined by pretreatment MRI, predict progression-free survival for patients with invasive cervical carcinoma. This study reveals the value of MRI as an adjunctive tool to clinical evaluation of invasive cervical cancer.