Abstract
Objective
To determine the value of the perfusion parameters in predicting short-term tumour response to synchronous radiochemotherapy for cervical squamous carcinoma.
Methods
Ninety-three patients with cervical squamous carcinoma later than stage IIB were included in this study. Perfusion CT was performed for all these patients who subsequently received the same synchronous radiochemotherapy. The patients were divided into responders and non-responders according to short-term response to treatment. Baseline perfusion parameters of the two groups were compared. The perfusion parameters that might affect treatment effect were analysed by using a multivariate multi-regression analysis.
Results
The responders group had higher baseline permeability-surface area product (PS) and blood volume (BV) values than the non-responders group (P < 0.05). There was no statistical difference in baseline mean transit time (MTT) and blood flow (BF) value between the two groups (P >0.05). At multivariate multi-regression analysis, BV, PS and tumour size were significant factors in the prediction of treatment effect. Small tumours usually had high PS and BV values, and thus had a good treatment response.
Conclusion
Perfusion CT can provide some helpful information for the prediction of the short-term effect. Synchronous radiochemotherapy may be more effective in cervical squamous carcinoma with higher baseline PS and BV.
Key Points
• Perfusion CT can reflect tumour vascular physiology in cervical squamous carcinoma.
• Perfusion CT helps predict the short-term effect before treatment
• Synchronous radiochemotherapy may be more effective in patients with higher baseline BV and PS.
Similar content being viewed by others
References
Nam H, Park W, Huh SJ et al (2007) The prognostic significance of tumour regression during radiotherapy and concurrent chemoradiotherapy for cervical cancer using MRI. Gynecol Oncol 107:320–325
Wang J, Wu N, Cham MD et al (2009) Tumor response in patients with advanced non-small cell lung cancer: perfusion CT evaluation of chemotherapy and radiation therapy. AJR Am J Roentgenol 193:1090–1096
Bisdas S, Rumboldt Z, Wagenblast J et al (2009) Response and progression-free survival in oropharynx cell carcinoma assessed by pretreatment perfusion CT: comparison with tumor volume measurements. AJNR Am J Neuroradiol 30:793–799
Chen Y, Zhang J, Dai J et al (2010) Angiogenesis of renal cell carcinoma: perfusion CT findings. Abdom Imaging 35:622–628
Ash L, Teknos TN, Gandhi D et al (2009) Head and neck squamous cell carcinoma: CT perfusion can help noninvasively predict intratumoral microvessel density. Radiology 251:422–428
Surlan-Popovic K, Bisdas S, Rumboldt Z et al (2010) Changes in perfusion CT of advanced squamous cell carcinoma of the head and neck treated during the course of concomitant chemoradiotherapy. AJNR Am J Neuroradiol 31:570–575
Zhang Q, Yuan ZG, Wang DQ et al (2010) Perfusion CT findings in liver of patients with tumor during chemotherapy. World J Gastroenterol 16:3202–3205
Lind JS, Meijerink MR, Dingemans AM et al (2010) Dynamic contrast-enhanced CT in patients treated with sorafenib and erlotinib for non-small cell lung cancer: a new method of monitoring treatment? Eur Radiol 20:2890–2898
d’Assignies G, Couvelard A, Bahrami S et al (2009) Pancreatic endocrine tumors: tumor blood flow assessed with perfusion CT reflects angiogenesis and correlates with prognostic factors. Radiology 250:407–416
Fournier LS, Oudard S, Thiam R et al (2010) Metastatic renal carcinoma: evaluation of antiangiogenic therapy with dynamic contrast-enhanced CT. Radiology 256:511–518
Hayano K, Shuto K, Koda K et al (2009) Quantitative measurement of blood flow using perfusion CT for assessing clinicopathologic features and prognosis in patients with rectal cancer. Dis Colon Rectum 52:1624–1629
Petralia G, Preda L, Giugliano G et al (2009) Perfusion computed tomography for monitoring induction chemotherapy in patients with squamous cell carcinoma of the upper aerodigestive tract: correlation between changes in tumor perfusion and tumor volume. J Comput Assist Tomogr 33:552–559
Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92:205–216
Pandharipande PV, Krinsky GA, Rusinek H et al (2005) Perfusion imaging of the liver: current challenges and future goals. Radiology 234:661–673
Park M, Dipl EK, Kim M et al (2009) Perfusion CT: noninvasive surrogate marker for stratification of pancreatic cancer response to concurrent chemo- and radiation therapy. Radiology 250:110–117
Hegenscheid K, Behrendt N, Rosenberg C et al (2010) Assessing early vascular changes and treatment response after laser-induced thermotherapy of pulmonary metastases with perfusion CT: initial experience. AJR Am J Roentgenol 194:1116–1123
Haider MA, Milosevic M, Fyles A et al (2005) Assessment of tumor microenvironment in cervix cancer using dynamic contrast enhanced CT, interstitial fluid pressure and oxygen measurements. Int J Radiat Oncol Biol Phys 62:1100–1107
Tai JH, Tessier J, Ryan AJ et al (2010) Assessment of acute antivascular effects of vandetanib with high-resolution dynamic contrast-enhanced computed tomographic imaging in a human colon tumor xenograft model in the rude rat. Neoplasia 12:697–707
Ng CS, Wang X, Faria SC et al (2010) Perfusion CT in patients with metastatic renal cell carcinoma treated with interferon. AJR Am J Roentgenol 194:166–171
Goh V, Halllgan S, Gharypuray A et al (2008) Quantitative assessment of colorectal cancer tumor vascular parameters by using perfusion CT: influence of tumor region of interest. Radiology 247:726–732
Bellomi M, Petralia G, Sonzogni A et al (2007) CT perfusion for the monitoring of neoadjuvant chemotherapy and radiation therapy in rectal carcinoma: initial experience. Radiology 244:486–493
Makari Y, Yasuda T, Doki Y et al (2007) Correlation between tumor blood flow assessed by perfusion CT and effect of neoadjuvant therapy in advanced esophageal cancers. J Surg Oncol 96:220–229
Goh V, Halligan S, Daley F et al (2008) Colorectal tumor vascularity: quantitative assessment with multidetector CT—do tumor perfusion measurements reflect angiogenesis? Radiology 249:510–517
Hermans R, Van den Bogaert W (2009) Outcome prediction after surgery and chemoradiation of head-and-neck squamous cell carcinoma (HNSCC), using baseline perfusion computed tomography (CT) microcirculatory parameters vs. tumor volume. Int J Radiat Oncol Biol Phys 74:1307
Goh V, Halligan S, Hugill JA et al (2005) Quantitative colorectal cancer perfusion measurement using dynamic contrast-enhanced multidetector-row computed tomography: effect of acquisition time and implications for protocols. J Comput Assist Tomogr 29:59–63
Yamashita Y, Baba T, Baba Y et al (2000) Dynamic contrast-enhancement MR imaging of uterine cervical cancer: pharmacokinetic analysis with histopathologic correlation and its importance in predicting the outcome of radiation therapy. Radiology 216:803–809
Šurlan-Popovič K, Bisdas S, Rumboldt Z et al (2010) Changes in perfusion CT of advanced squamous cell carcinoma of the head and neck treated during the course of concomitant chemoradiotherapy. AJNR Am J Neuroradiol 31:570–575
Zhang H, Pan Z, Du L et al (2008) Advanced gastric cancer and perfusion imaging using a multidetector row computed tomography: correlation with prognostic determinants. Korean J Radiol 9:119–127
Meijerink MR, van Cruijsen H, Hoekman K et al (2007) The use of perfusion CT for the evaluation of therapy combining AZD2171 with gefitinib in cancer patients. Eur Radiol 17:1700–1713
Yang HF, Du Y, Ni JX et al (2010) Perfusion computed tomography evaluation of angiogenesis in liver cancer. Eur Radiol 20:1424–1430
Mayr NA, Yuh WT, Zheng J et al (1998) Prediction of tumour control in patients with cervical cancer: analysis of combined volume and dynamic enhancement patterns by MR imaging. AJR Am J Roentgenol 170:177–182
Lyng H, Vorren A, Sundfor K et al (2001) Intra- and intertumor heterogeneity in blood perfusion of human cervical cancer before treatment and after radiotherapy. Int J Cancer 96:182–190
Mayr NA, Yuh WT, Arnholt JC et al (2000) Pixel analysis of MR perfusion imaging in predicting radiation outcome in cervical cancer. J Magn Reson Imaging 12:1027–1033
Bhosale P, Peungjesada S, Devine C et al (2010) Role of magnetic resonance imaging as a adjunct to clinical staging in cervical carcinoma. J Comput Assist Tomogr 34:855–864
Stenstedt K, Kellström AC, Fridsten S et al (2011) Impact of MRI in the management and staging of cancer of the uterine cervix. Acta Oncol 50:420–426
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Li, X.S., Fan, H.X., Zhu, H.X. et al. The value of perfusion CT in predicting the short-term response to synchronous radiochemotherapy for cervical squamous cancer. Eur Radiol 22, 617–624 (2012). https://doi.org/10.1007/s00330-011-2280-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-011-2280-6