Gynecological Cancer

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TU_13_3467 - Comparison of Single Slice Versus Volume Based Evaluation of 3T MRI Apparent Diffusion Coefficient (ADC) Values in a Prospective Imaging Trial of Definitive Chemoradiation for Locally Advanced Cervical Cancer Patients

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Comparison of Single Slice Versus Volume Based Evaluation of 3T MRI Apparent Diffusion Coefficient (ADC) Values in a Prospective Imaging Trial of Definitive Chemoradiation for Locally Advanced Cervical Cancer Patients
M. Kamrava1, M. Luu1, D. Margolis2, M. Brown3, J. H. Tavares Guerreiro F4, and D. G. Marconi4; 1Cedars-Sinai Medical Center, Los Angeles, CA, 2Cornell, New York, NY, 3University of California Los Angeles, Los Angeles, CA, 4Barretos Cancer Hospital, Barretos, Brazil

Purpose/Objective(s): To compare the results of single slice region of interest (ROI) versus volume based ROI evaluation of ADC findings in women undergoing definitive chemoradiation treatment for locally advanced cervical cancer.

Materials/Methods: This was an IRB approved prospective study of 3T MRI imaging that included DWI (b values 0, 900 sec/mm2) at 3 different time-points (baseline – MRI 1, after 45 Gy – MRI 2, and 3 months after treatment – MRI 3) in locally advanced cervical cancer patients undergoing standard of care treatment. A single slice ROI was identified to calculate a mean ADC value (x10-3 mm2/s) on MRI 1, 2, and 3 by one of three radiologists. Tumor volume was calculated based on anterior-posterior/left-right/and superior-inferior 2-dimmensional (2D) measurements. An independent radiologist with no knowledge of the findings of the single slice ROI analysis segmented the gross tumor volume on MRI 1, 2, and 3 to calculate a mean DWI as well as a volume. Statistical comparison between single slice and volume based measurements was performed using a linear mixed effects model with a fixed effect for single slice/volume based measurement time-points, and the interaction of single slice/volume based measurement time-points, with a random intercept for each patient. A post hoc pairwise comparison of least square means was performed using the Satterthwaite method. P-values were adjusted for multiple comparisons using the Bonferroni method for 15 tests. 32 women were treated with definitive chemoradiation between 6/2014-6/2015. Mean patient age was 50 yo, 30 pts had squamous cell cancer, 21 had FIGO Stage IB/IIB disease and 9 had FIGO stage IIIB disease. Patients most standardly received 3D conformal external beam to 45 Gy with concurrent weekly cisplatin chemotherapy followed by 2-dimmentional 7 Gy x 4 HDR tandem and ovoid treatment.

Results: Mean gross tumor volume (standard deviation) based on 2D measurements on MRI1, 2, and 3 were: 64.0 (46.2), 7.5 (10.7), and 0.5 (1.7) cc. Mean gross tumor volume based on volume based measurements on MRI 1, 2, and 3 were: 63.8 (46.7), 7.2 (8.7), and 4.2 (20.3) cc. There were no significant differences in volumes when comparing the measurements taken at the same time point (ie MRI 1 2D vs MRI 1 volume based measurement). Mean ADC (standard deviation) based on single slice measurements on MRI 1, 2, and 3 were: 890.1 (183.7), 1430.3 (321.9), and 1968.6 (529.5). Mean ADC based on volume based measurements on MRI 1, 2, and 3 were: 990.5 (172.1), 1622.3 (368.4), and 2091.8 (468.1). There were no significant differences in DWI values when comparing single slice versus volume based measurements taken at similar time points.

Conclusion: When considering the mean ADC, single slice ROI findings are similar to volume based measurements. These findings provide preliminary data that single slice analysis may be sufficient compared with more sophisticated volume based measurements.

Author Disclosure: M. Kamrava: None. M. Luu: None. D. Margolis: None. M. Brown: None. J.H. Tavares Guerreiro F: None.

Mitchell Kamrava, MD

Disclosure:
Employment
Cedars Sinai Medical Center: Chief Brachytherapy Service: Employee

Compensation
Augmenix: Speaker's Bureau

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TU_13_3467 - Comparison of Single Slice Versus Volume Based Evaluation of 3T MRI Apparent Diffusion Coefficient (ADC) Values in a Prospective Imaging Trial of Definitive Chemoradiation for Locally Advanced Cervical Cancer Patients



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