Using MR imaging to predict and evaluate the response of invasive cervical carcinoma to systemic chemotherapy.

Abstract

The goal of our study was to evaluate the accuracy of MR imaging in predicting the response of invasive cervical carcinoma to systemic neoadjuvant chemotherapy, to observe with MR imaging the difference in tumor response to chemotherapy between treatment cycles, and to correlate tumor size between MR imaging after chemotherapy and surgical specimen. Pelvic MR imaging was performed before and after chemotherapy in 41 patients with invasive cervical carcinoma. The difference in tumor reduction between the second course and the third or fourth course of treatment was statistically evaluated in 12 patients. MR images obtained after chemotherapy were compared with surgical specimens to determine residual tumor size in 10 patients. Tumor volume, complete replacement of cervical stroma with carcinoma, and uterine body involvement by tumor observed in the MR images before treatment were found to be significant factors in predicting tumor response. No difference in tumor reduction was found between the second course and the third or fourth course of chemotherapy. Estimates made on MR imaging of tumor size after chemotherapy were within 5 mm of the resected samples. Pelvic MR imaging proved useful in predicting and assessing the response of invasive cervical carcinoma to chemotherapy.