Journal
RADIOLOGIA MEDICA
Volume 124, Issue 10, Pages 955-964Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s11547-019-01055-3
Keywords
Magnetic resonance imaging; Uterine cervical neoplasm; Prognosis; Tumor heterogeneity; Diffusion-weighted imaging
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Introduction To determine the performance of texture analysis and conventional MRI parameters in predicting tumoral response to neoadjuvant chemotherapy and to assess whether a relationship exists between texture tissue heterogeneity and histological type of uterine cervix cancer. Method and materials Twenty-eight patients with local advanced cervical cancer (FIGO IB2-IIIB), underwent MRI before chemotherapy. Texture analysis parameters were quantified on T2-weighted sequences, as well as the maximum diameter expressed in mm. ADC values were obtained on the ADC map. Statistical analysis included unpaired t test and ROC curve. Results No statistical correlation was found between conventional parameters and response to NACT. Mean and skewness showed a strong correlation with the histological type: Adenocarcinomas presented higher mean and skewness values (69.8 +/- 10.5 and 0.55 +/- 0.19) in comparison with squamous cell carcinomas. Using a cutoff value >= 29 for mean it was possible to differentiate the two histological types with a sensitivity of 100% and a specificity of 81%. Kurtosis showed a positive correlation with tumor response to NACT resulting higher in responders (v.m. 5.7 +/- 1.1) in comparison with non-responders (2.3 +/- 0.5). The optimal Kurtosis cutoff value for the identification of non-responders tumors was <= 3.7 with a sensitivity of 92% and a specificity of 75%. Conclusion Texture analysis applied to T2-weighted images of uterine cervical cancer exceeded the role of conventional prognostic factors in predicting tumoral response; moreover, they showed a potential role to differentiate histological tumor types.
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