Quantitative imaging biomarkers as prognostic indicators in squamous cell cervical carcinoma: a retrospective cohort
Mayur Virarkar1, Sanaz Javadi2, Aatiqah Aziz2
1University of Florida, Jacksonville, USA. mayur.virarkar@jax.ufl.edu.
Objective:
To evaluate quantitative imaging biomarkers, including MRI tumor size, apparent diffusion coefficient (ADC), arterial-phase enhancement, and PET maximum standardized uptake value (SUVmax), as prognostic indicators of overall survival (OS), recurrence-free survival (RFS), and treatment response in cervical squamous cell carcinoma (SCC).
Materials And Methods:
Fifty patients with biopsy-proven SCC who underwent pre- and post-treatment MRI and FDG-PET/CT were retrospectively analyzed. Tumor dimensions (axial, sagittal), ADC, SUVmax, and arterial enhancement were assessed. Survival was estimated by Kaplan-Meier, and associations with OS and RFS were tested using Cox regression. Logistic regression was used to determine predictors of treatment response according to RECIST and PERCIST criteria.
Results:
Tumor size, SUVmax, and ADC changed significantly post-treatment (p < 0.001). Persisting arterial enhancement was seen in 35% of tumors. Higher post-treatment SUVmax predicted worse OS (HR = 1.078, p = 0.008) and RFS (HR = 1.049, p = 0.046). Larger residual sagittal tumor size showed borderline associations with inferior OS (HR = 1.38, p = 0.089) and RFS (HR = 1.31, p = 0.057). Increases in tumor size significantly correlated with persistent arterial enhancement (axial OR = 1.58, p = 0.025; sagittal OR = 1.93, p = 0.002). Persistent enhancement trended toward worse RFS (HR ≈ 2.24, p = 0.107). In multivariable analysis, post-treatment pelvic lymph node positivity remained independently associated with poorer RFS. Baseline ADC predicted metabolic response: a higher pre-treatment ADC was associated with a failure to achieve a partial metabolic response per PERCIST (OR = 1.007, p = 0.015).
Conclusion:
Post-treatment SUVmax, residual tumor size, arterial enhancement, and pelvic lymph node involvement are key prognostic indicators in cervical SCC. Persistent enhancement may reflect treatment-resistant vascularity. Integrating these biomarkers into clinical workflows may improve risk stratification and guide personalized management.
More Related Videos
07:29Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
07:32Author Spotlight: Investigating Immune Cell Dynamics in the Tumor Microenvironment — Challenges and Innovations in Cancer Prognosis
Published on: April 12, 2024
