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KMID : 1038620120300020070
Radiation Oncology Journal
2012 Volume.30 No. 2 p.70 ~ p.77
Method of tumor volume evaluation using magnetic resonance imaging for outcome prediction in cervical cancer treated with concurrent chemotherapy and radiotherapy
Kim Hun-Jung

Kim Woo-Chul
Abstract
Purpose: To evaluate the patterns of tumor shape and to compare tumor volume derived from simple diameter-based ellipsoid measurement with that derived from tracing the entire tumor contour using region of interest (ROI)-based 3D volumetry with respect to the prediction outcome in cervical cancer patients treated with concurrent chemotherapy and radiotherapy.

Materials and Methods: Magnetic resonance imaging was performed in 98 patients with cervical cancer (stage IB-IIIB). The tumor shape was classifi ed into two categories: ellipsoid and non-ellipsoid shape. ROI-based volumetry was derived from each magnetic resonance slice on the work station. For the diameter-based surrogate ¡°ellipsoid volume,¡± the three orthogonal diameters were measured to calculate volume as an ellipsoid.

Results: The more than half of tumor (55.1%) had a non-ellipsoid confi guration. The predictions for outcome were consistent between two volume groups, with overall survival of 93.6% and 87.7% for small tumor (<20 mL), 62.9% and 69.1% for intermediate-size tumor (20-39 mL), and 14.5% and 16.7% for large tumors (¡Ã40 mL) using ROI and diameter based measurement, respectively. Disease-free survival was 93.8% and 90.6% for small tumor, 54.3% and 62.7% for intermediate-size tumor, and 13.7% and 10.3% for large tumor using ROI and diameter based method, respectively. Differences in outcome between size groups were statistically signifi cant, and the differences in outcome predicted by the tumor volume by two different methods.

Conclusion: Our data suggested that large numbers of cervical cancers are not ellipsoid. However, simple diameter-based tumor volume measurement appears to be useful in comparison with ROI-based volumetry for predicting outcome in cervical cancer patients.
KEYWORD
Cervical cancer, Magnetic resonance imaging, Tumor volume, Concurrent chemotherapy and radiotherapy
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