Prediction of pelvic control using MRI for patients with cervical carcinoma treated with radiotherapy

PURPOSE: To investigate the usefulness of MRI for predicting pelvic control (PC) of cervical cancer treated with radiation therapy (RT). MATERIALS AND METHODS: Forty-four cervical cancer patients treated with definitive RT were retrospectively analyzed. MRIs were completed before and after RT, and the longest diameter (LD) of the residual tumor was measured on post-RT MRI. Pathologic evaluation for residual tumor was also performed. Therapeutic response was assessed using MRI. Median follow-up time for the 44 patients was 34 months. The correlations between PC rate, MRI, and pathological findings were investigated. RESULTS: The 3-year PC rates of LD = 0 cm (n = 23) after RT, 0 2 cm (n = 6) were 85%, 80%, and 0%, respectively (p < 0.0001). There was no significant difference in PC according to the presence (n = 8) or absence (n = 36) of residue in the pathologic materials (3-year PC rate: 63% vs. 77%). Three-year PC rates according to therapeutic responses were 85% in complete response (n = 23), 72% in partial response (n = 18), and 0% in stable disease or progressive disease (n = 3) (p < 0.0001). CONCLUSION: MRI is useful for predicting PC in cervical cancer treated with RT, and LD greater than 2 cm after RT is a good marker for poor PC.