Imaging Found Useful as Predictive Tool for Gynecological Cancer

DWI and PET-CT imaging are useful for predictive and molecular testing for gynecological malignancies according to a new study presented at the annual meeting of the Radiological Society of North America (RSNA 2015).

According to the researchers imaging has so far been used as a descriptive and morphological tool, but is now becoming a useful biomarker for predicting the results of cancer therapy over the long term, and a patient's chances of survival. Micro-environmental imaging of tissue, cell metabolism, and genomes are now necessary in gynecology because current chemotherapeutic agents are targeted to specific molecules, and cellular pathways, and imaging can help treat these patients.

The research was presented by researchers from the Women's Imaging department of the Massachusetts General Hospital (Boston, MA, USA). Researchers from the Samsung Medical Center, Sungkyunkwan University School of Medicine (Seoul, Republic of Korea) presented the results of another study showing the prognostic value of Diffusion Weighted Magnetic Resonance Imaging (DWI-MRI) and Positron Emission Tomography/Computed Tomography (PET/CT) during Concurrent Chemotherapy (CCRT) of cervical cancer. The researchers in Seoul used DWI as an imaging biomarker for predicting tumor aggressiveness and disease progression. The Seoul study included 67 patients that underwent CCRT for locally advanced cervical cancer, and were scanned using DWI-MRI and PET/CT before and during treatment. Another study showed that Intra-Voxel Incoherent Motion (IVIM) diffusion weighted MRI was useful in predicting and monitoring the effectiveness of Neo-Adjuvant Chemotherapy (NACT) for cervical cancer.

The advantages of DWI include its speed, and the fact that it is noninvasive. In addition, DWI imaging findings can be quantified using the Apparent Diffusion Coefficient (ADC). PET-CT imaging on the other hand involves extensive pre-imaging preparation, and ionizing radiation.

Dr. Jung Jae Park, Samsung Medical Center, said, “We wanted to compare the predictive value of an imaging marker derived from DWI (ADC value) and PET-CT (SUV value) to determine that these imaging techniques could be potentially interchangeable for predicting patients' outcomes. The most important and original finding of this study was that the degrees of change in tumor ADC and SUV are similar. And they revealed similar prognostic performance for predicting patient prognosis regarding disease progression after CCRT of cervical cancer."

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Massachusetts General Hospital
Samsung Medical Center