USING MR-IMAGING TO PREDICT AND EVALUATE THE RESPONSE OF INVASIVE CERVICAL-CARCINOMA TO SYSTEMIC CHEMOTHERAPY

OBJECTIVE. The goal of our study was to evaluate the accuracy of MR im aging in predicting the response of invasive cervical carcinoma to sys temic neoadjuvant chemotherapy, to observe with MR imaging the differe nce in tumor response to chemotherapy between treatment cycles, and to correlate tumor size between MR imaging after chemotherapy and surgic al specimen. SUBJECTS AND METHODS. Pelvic MR imaging was performed bef ore and after chemotherapy in 41 patients with invasive cervical carci noma. 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. R ESULTS. Tumor volume, complete replacement of cervical stroma with car cinoma, and uterine body involvement by tumor observed in the MR image s 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. Estimat es made on MR imaging of tumor size after chemotherapy were within 5 m m of the resected samples. CONCLUSION. Pelvic MR imaging proved useful in predicting and assessing the response of invasive cervical carcino ma to chemotherapy.