Journal article
Utilization of functional MRI in the diagnosis and management of cervical cancer
Frontiers in oncology, v 12, 1030967
11 Nov 2022
PMID: 36439416
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
IntroductionImaging is integral part of cervical cancer management. Currently, MRI is used for staging, follow up and image guided adaptive brachytherapy. The ongoing IQ-EMBRACE sub-study is evaluating the use of MRI for functional imaging to aid in the assessment of hypoxia, metabolism, hemodynamics and tissue structure. This study reviews the current and potential future utilization of functional MRI imaging in diagnosis and management of cervical cancer. MethodsWe searched PubMed for articles characterizing the uses of functional MRI (fMRI) for cervical cancer. The current literature regarding these techniques in diagnosis and outcomes for cervical cancer were then reviewed. ResultsThe most used fMRI techniques identified for use in cervical cancer include diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE). DCE-MRI indirectly reflects tumor perfusion and hypoxia. This has been utilized to either characterize a functional risk volume of tumor with low perfusion or to characterize at-risk tumor voxels by analyzing signal intensity both pre-treatment and during treatment. DCE imaging in these situations has been associated with local control and disease-free survival and may have predictive/prognostic significance, however this has not yet been clinically validated. DWI allows for creation of ADC maps, that assists with diagnosis of local malignancy or nodal disease with high sensitivity and specificity. DWI findings have also been correlated with local control and overall survival in patients with an incomplete response after definitive chemoradiotherapy and thus may assist with post-treatment follow up. Other imaging techniques used in some instances are MR-spectroscopy and perfusion weighted imaging. T2-weighted imaging remains the standard technique used for diagnosis and radiation treatment planning. In many instances, it is unclear what additional information functional-MRI techniques provide compared to standard MRI imaging. ConclusionsFunctional MRI provides potential for improved diagnosis, prediction of treatment response and prognostication in cervical cancer. Specific sequences such as DCE, DWI and ADC need to be validated in a large prospective setting prior to widespread use. The ongoing IQ-EMBRACE study will provide important clinical information regarding these imaging modalities.
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Details
- Title
- Utilization of functional MRI in the diagnosis and management of cervical cancer
- Creators
- Hirsch Matani - Allegheny Health NetworkAnkur K. K. Patel - Allegheny Hlth Network Canc Inst, Div Radiat Oncol, Pittsburgh, PA 15224 USAZachary D. D. Horne - Allegheny Health NetworkSushil Beriwal - Allegheny Health Network
- Publication Details
- Frontiers in oncology, v 12, 1030967
- Publisher
- Frontiers Media Sa
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000890028200001
- Scopus ID
- 2-s2.0-85142641350
- Other Identifier
- 991021897396304721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology