Value of R2∗ obtained from T2∗-weighted imaging in predicting the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy

Abstract

Background To prospectively investigate the value of R2∗ in predicting the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy. Methods Sixty-five patients with biopsy-proven cervical squamous carcinoma were enrolled in our study. All these subjects underwent multi-echo T2∗-weighted MR imaging on a 3.0 Tesla MR scanner, and tumor R2∗ was calculated. The patients were divided into the responders and the nonresponders according to treatment effect. Tumor R2∗ values of these two groups were compared. The relationship between tumor R2∗ and prognosis after therapy was analyzed. Results The responder group had lower R2∗ value than the nonresponder group (P=0.02). The area under the receiver operating characteristics curve for tumor R2∗ in discriminating responders from nonresponders was 0.769. A cutoff value of 23.87 Hz for tumor R2∗ resulted in a sensitivity of 78.3% and a specificity of 67.6%. The low R2∗ group (≤28.37 Hz) had longer median progression-free survival period and overall survival period (P=0.01, 0.03). Multivariate analysis showed that tumor R2∗ was a significant prognostic factor for progression-free survival and overall survival (adjusted hazards ratio=5.34, 4.78; P=0.02, 0.01). Conclusion R2∗ value obtained from T2∗-weighted imaging, as an imaging biomarker, may be an important predictor for the prognosis of advanced cervical squamous carcinoma treated with concurrent chemoradiotherapy. J. Magn. Reson. Imaging 2015;42:681-688.