Tumor volume and subvolume concordance between FDG-PET/CT and diffusion-weighted MRI for squamous cell carcinoma of the cervix

J Magn Reson Imaging. 2013 Feb;37(2):431-4. doi: 10.1002/jmri.23830. Epub 2012 Sep 28.

Abstract

Purpose: To compare [(18)F]fluorodeoxyglucose (FDG)/positron emission tomography (PET)/computed tomography (CT) and magnetic resonance imaging (MRI) for evaluating patients with cervical cancer. We compared tumor characteristics on FDG-PET and apparent diffusion coefficient (ADC) maps on diffusion-weighted MRI (DWI) to evaluate concordance of two functional imaging techniques.

Materials and methods: Twenty women with cervical cancer underwent pretreatment FDG-PET/CT and pelvic MRI. Images were rigidly fused by pelvic anatomy using coregistration software. Tumor contours on PET images were generated by autosegmentation of the region containing at least 40% of the maximum standardized uptake value (SUV). DWI contours were generated by manual segmentation. Tumor volume similarity was evaluated using the [PET]/[ADC] volume proportion, Dice's coefficient, and the mean SUV isothreshold at the surface of each ADC contour. Tumor subvolume similarity was evaluated with analysis of variance (ANOVA).

Results: The [PET]/[ADC] volume proportion was 0.88 ± 0.14. Dice's coefficient between PET and ADC tumor contours was 0.76 ± 0.06. The mean SUV isothreshold at the ADC-delineated tumor surface was 34 ± 4%. Subvolumes with increased metabolic activity on FDG-PET also had more restricted diffusion on DWI (P < 0.0001, ANOVA).

Conclusion: Concordance of functional imaging was observed between FDG-PET and DWI for cervical cancer. Tumor subvolumes with increased metabolic activity on FDG-PET also have greater cell density by DWI.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Carcinoma, Squamous Cell / diagnosis*
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods*
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Multimodal Imaging / methods*
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*
  • Tumor Burden
  • Uterine Cervical Neoplasms / diagnosis*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18