Multiparametric PET/MR (PET and MR-IVIM) for the evaluation of early treatment response and prediction of tumor recurrence in patients with locally advanced cervical cancer
To assess the value of Fifty-one patients with LACC underwent pelvic PET/MR scans with an IVIM sequence at two time-points (pretreatment [pre] and midtreatment [mid]). Pre- and mid-PET parameters (SUV Thirty-two patients were classified into the good response (GR) group with TESR ≥ 50%, and 19 patients were categorized into the poor response (PR) group with TESR < 50%. Δ%D (p = 0.013) and Δ%F (p = 0.006) are independently related to TESR with superior combined diagnostic ability (AUC = 0.901). Pre-TLG, Δ%D, and suspicious lymph node metastasis (SLNM) were selected for the construction of the combined prediction model. The model for identifying the patients with high risk of tumor recurrence reached a moderate predictive ability and good stability with c-index of 0.764 (95% CI, 0.672-0.855). The combined prediction model based on pretreatment PET metabolic parameter (pre-TLG), IVIM-D percentage changes, and LNs status provides great potential to identify the LACC patients with high risk of recurrence at early stage of CCRT. • PET/MR plus IVIM offers various complementary information for LACC. • IVIM-D and IVIM-F percentage changes are independently related to tumor early shrinkage rates. • The combined prediction model can help identify the LACC patients with high risk of tumor recurrence.