Radiation damage measurement in physiological environment in cervical cancer

K. L. Szluha, K. Lazányi, É Pintye, A. Kovács, A. Opauszki, R. Poka, K. Benko, J. Toth, C. András, A. Horváth

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Purpose: The aim of this study was to measure radiotherapy induced changes in cervical cancer patients examined by means of contrast-enhanced dynamic magnetic resonance imaging (DCE-MRI). Patients and Methods Ten patients with T2a cervical cancer were entered into the trial. All of them underwent Wertheim-Meigs operation. DCE-MRI images were examined before and after 3x6 Gy intracavitary high dose rate radiotherapy (HDRRT) with Ir 192. A DCE-MRI protocol was performed including T1 weighted spin-echo and dynamic Tl-weighted axial images after intravenous Gd-DTPA administration. The DCE-MRI data obtained were analyzed using calculations of Signal Intensity Ratio (SIR) and, a new indicator, Ratio of Signal Intensity changes in time (RISI). Measurable signal enhancement of healthy uterine and that of cancerous cervical tissue were examined in respective anatomic locations prior to radiotherapy and after 18 Gy HDR brachytherapy irradiation. Muscular and fatty tissue enhancement were measured as control. The degree of contrast enhancement changes in patients who had undergone neoadjuvant irradiation, was calculated and compared with both pathological findings after Wertheim-Meigs operation and clinical response. Results: In 10 patients who underwent abdominal hysterectomy and lymphadenectomy, accurate assessment of tumor size and infiltration was possible using preoperative DCE-MRI. SIR and RISI averages of cervical cancer (89.06% and 15.36 /sec) and those of healthy uterine tissues showed significant differences before and after HDRRT, with optimum measurability in the early enhancement phase during the first 30 seconds. Both intratumoral enhancement differences and individual changes after radiotherapy are characteristic. SIR and RISI levels were higher than 90% and 9.5 /sec, respectively, and decreased better in well responding patients. A tumor activity decrease was predicted by DCE-MRI only in cervical cancers where SIR and RISI decreases exceeded 40% after HDRRT. With the latter patients, better disease free survival (DFS) and local control (LC) rates were observed. Conclusions: In a preoperative evaluation comparative study, intra and inter-patient variability of contrast enhancement in DCE-MRI was assessed. DCE-MRI provide important information about individual tumor contrast enhancement activity in cervical cancer and its changes after radiotherapy, which may be helpful for therapy planning and assessing intratumoral activity changes. DCE-MRI may be useful for tumor response prediction as well.

Original languageEnglish
Title of host publicationAIP Conference Proceedings
Pages194-198
Number of pages5
Volume1080
DOIs
Publication statusPublished - 2008
Event5th International Conference on Radiation Damage in Biomolecular Systems, RADAM 2008 - Debrecen, Hungary
Duration: Jun 13 2008Jun 15 2008

Other

Other5th International Conference on Radiation Damage in Biomolecular Systems, RADAM 2008
CountryHungary
CityDebrecen
Period6/13/086/15/08

Fingerprint

radiation damage
cancer
radiation therapy
augmentation
tumors
dosage
irradiation
infiltration
magnetic resonance
planning
therapy
echoes
evaluation
predictions

Keywords

  • DCE-MRI
  • Pharmacokinetic analysis
  • Prediction of response
  • Radiation therapy
  • Tumor activity
  • Uterine cervical cancer

ASJC Scopus subject areas

  • Physics and Astronomy(all)

Cite this

Szluha, K. L., Lazányi, K., Pintye, É., Kovács, A., Opauszki, A., Poka, R., ... Horváth, A. (2008). Radiation damage measurement in physiological environment in cervical cancer. In AIP Conference Proceedings (Vol. 1080, pp. 194-198) https://doi.org/10.1063/1.3058981

Radiation damage measurement in physiological environment in cervical cancer. / Szluha, K. L.; Lazányi, K.; Pintye, É; Kovács, A.; Opauszki, A.; Poka, R.; Benko, K.; Toth, J.; András, C.; Horváth, A.

AIP Conference Proceedings. Vol. 1080 2008. p. 194-198.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Szluha, KL, Lazányi, K, Pintye, É, Kovács, A, Opauszki, A, Poka, R, Benko, K, Toth, J, András, C & Horváth, A 2008, Radiation damage measurement in physiological environment in cervical cancer. in AIP Conference Proceedings. vol. 1080, pp. 194-198, 5th International Conference on Radiation Damage in Biomolecular Systems, RADAM 2008, Debrecen, Hungary, 6/13/08. https://doi.org/10.1063/1.3058981
Szluha KL, Lazányi K, Pintye É, Kovács A, Opauszki A, Poka R et al. Radiation damage measurement in physiological environment in cervical cancer. In AIP Conference Proceedings. Vol. 1080. 2008. p. 194-198 https://doi.org/10.1063/1.3058981
Szluha, K. L. ; Lazányi, K. ; Pintye, É ; Kovács, A. ; Opauszki, A. ; Poka, R. ; Benko, K. ; Toth, J. ; András, C. ; Horváth, A. / Radiation damage measurement in physiological environment in cervical cancer. AIP Conference Proceedings. Vol. 1080 2008. pp. 194-198
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abstract = "Purpose: The aim of this study was to measure radiotherapy induced changes in cervical cancer patients examined by means of contrast-enhanced dynamic magnetic resonance imaging (DCE-MRI). Patients and Methods Ten patients with T2a cervical cancer were entered into the trial. All of them underwent Wertheim-Meigs operation. DCE-MRI images were examined before and after 3x6 Gy intracavitary high dose rate radiotherapy (HDRRT) with Ir 192. A DCE-MRI protocol was performed including T1 weighted spin-echo and dynamic Tl-weighted axial images after intravenous Gd-DTPA administration. The DCE-MRI data obtained were analyzed using calculations of Signal Intensity Ratio (SIR) and, a new indicator, Ratio of Signal Intensity changes in time (RISI). Measurable signal enhancement of healthy uterine and that of cancerous cervical tissue were examined in respective anatomic locations prior to radiotherapy and after 18 Gy HDR brachytherapy irradiation. Muscular and fatty tissue enhancement were measured as control. The degree of contrast enhancement changes in patients who had undergone neoadjuvant irradiation, was calculated and compared with both pathological findings after Wertheim-Meigs operation and clinical response. Results: In 10 patients who underwent abdominal hysterectomy and lymphadenectomy, accurate assessment of tumor size and infiltration was possible using preoperative DCE-MRI. SIR and RISI averages of cervical cancer (89.06{\%} and 15.36 /sec) and those of healthy uterine tissues showed significant differences before and after HDRRT, with optimum measurability in the early enhancement phase during the first 30 seconds. Both intratumoral enhancement differences and individual changes after radiotherapy are characteristic. SIR and RISI levels were higher than 90{\%} and 9.5 /sec, respectively, and decreased better in well responding patients. A tumor activity decrease was predicted by DCE-MRI only in cervical cancers where SIR and RISI decreases exceeded 40{\%} after HDRRT. With the latter patients, better disease free survival (DFS) and local control (LC) rates were observed. Conclusions: In a preoperative evaluation comparative study, intra and inter-patient variability of contrast enhancement in DCE-MRI was assessed. DCE-MRI provide important information about individual tumor contrast enhancement activity in cervical cancer and its changes after radiotherapy, which may be helpful for therapy planning and assessing intratumoral activity changes. DCE-MRI may be useful for tumor response prediction as well.",
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AU - Pintye, É

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AU - Opauszki, A.

AU - Poka, R.

AU - Benko, K.

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N2 - Purpose: The aim of this study was to measure radiotherapy induced changes in cervical cancer patients examined by means of contrast-enhanced dynamic magnetic resonance imaging (DCE-MRI). Patients and Methods Ten patients with T2a cervical cancer were entered into the trial. All of them underwent Wertheim-Meigs operation. DCE-MRI images were examined before and after 3x6 Gy intracavitary high dose rate radiotherapy (HDRRT) with Ir 192. A DCE-MRI protocol was performed including T1 weighted spin-echo and dynamic Tl-weighted axial images after intravenous Gd-DTPA administration. The DCE-MRI data obtained were analyzed using calculations of Signal Intensity Ratio (SIR) and, a new indicator, Ratio of Signal Intensity changes in time (RISI). Measurable signal enhancement of healthy uterine and that of cancerous cervical tissue were examined in respective anatomic locations prior to radiotherapy and after 18 Gy HDR brachytherapy irradiation. Muscular and fatty tissue enhancement were measured as control. The degree of contrast enhancement changes in patients who had undergone neoadjuvant irradiation, was calculated and compared with both pathological findings after Wertheim-Meigs operation and clinical response. Results: In 10 patients who underwent abdominal hysterectomy and lymphadenectomy, accurate assessment of tumor size and infiltration was possible using preoperative DCE-MRI. SIR and RISI averages of cervical cancer (89.06% and 15.36 /sec) and those of healthy uterine tissues showed significant differences before and after HDRRT, with optimum measurability in the early enhancement phase during the first 30 seconds. Both intratumoral enhancement differences and individual changes after radiotherapy are characteristic. SIR and RISI levels were higher than 90% and 9.5 /sec, respectively, and decreased better in well responding patients. A tumor activity decrease was predicted by DCE-MRI only in cervical cancers where SIR and RISI decreases exceeded 40% after HDRRT. With the latter patients, better disease free survival (DFS) and local control (LC) rates were observed. Conclusions: In a preoperative evaluation comparative study, intra and inter-patient variability of contrast enhancement in DCE-MRI was assessed. DCE-MRI provide important information about individual tumor contrast enhancement activity in cervical cancer and its changes after radiotherapy, which may be helpful for therapy planning and assessing intratumoral activity changes. DCE-MRI may be useful for tumor response prediction as well.

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KW - Pharmacokinetic analysis

KW - Prediction of response

KW - Radiation therapy

KW - Tumor activity

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