Patients with disease recurrence also had a lower ADC both pre- and posttreatment, as well as had a smaller interval change in ADC values [65]. In a retrospective study with 102 patients, tumors with infiltrative growth pattern on MRI were associated with a lower overall and locoregional recurrence-free survival rates after chemoradiation [66]. Finally, MRI is also helpful for assessment of posttreatment complications [54]. MRI Pelvis Without IV Contrast MRI pelvis without IV contrast may have a role in assessment of response of cervical cancer after chemoradiation; however, use of IV contrast may add value. In a study of 185 patients, MRI was able to demonstrate the change in the size of the primary tumor after radiation, and initial tumor size and the rate of decrease of tumor size were significantly associated with local recurrence-free and overall survival rates [58]. A meta-analysis including 4 studies and 147 patients, MRI had 83.5% sensitivity, 88.5% specificity, and 84.3% accuracy for detection of residual tumor after brachytherapy; however, it remains unclear if these results also translate to MRI without IV contrast [59]. MRI parameters on DWI and DCE images also likely have a role in assessment of these patients. In a meta- analysis, pretreatment ADC values on MRI alone were not reliable in assessing treatment response [62]; however, other studies have indicated that multiparametric MRI with DWI and DCE images together may help predict response to chemoradiation [63,64]. In another small retrospective study in 32 patients, T2-weighted images were shown to be useful in assessing changes in the tumor volume [57]. In a retrospective study with 102 patients, tumors with infiltrative growth pattern on MRI were associated with a lower overall and locoregional recurrence-free survival rates after chemoradiation [66].
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. Patients with disease recurrence also had a lower ADC both pre- and posttreatment, as well as had a smaller interval change in ADC values [65]. In a retrospective study with 102 patients, tumors with infiltrative growth pattern on MRI were associated with a lower overall and locoregional recurrence-free survival rates after chemoradiation [66]. Finally, MRI is also helpful for assessment of posttreatment complications [54]. MRI Pelvis Without IV Contrast MRI pelvis without IV contrast may have a role in assessment of response of cervical cancer after chemoradiation; however, use of IV contrast may add value. In a study of 185 patients, MRI was able to demonstrate the change in the size of the primary tumor after radiation, and initial tumor size and the rate of decrease of tumor size were significantly associated with local recurrence-free and overall survival rates [58]. A meta-analysis including 4 studies and 147 patients, MRI had 83.5% sensitivity, 88.5% specificity, and 84.3% accuracy for detection of residual tumor after brachytherapy; however, it remains unclear if these results also translate to MRI without IV contrast [59]. MRI parameters on DWI and DCE images also likely have a role in assessment of these patients. In a meta- analysis, pretreatment ADC values on MRI alone were not reliable in assessing treatment response [62]; however, other studies have indicated that multiparametric MRI with DWI and DCE images together may help predict response to chemoradiation [63,64]. In another small retrospective study in 32 patients, T2-weighted images were shown to be useful in assessing changes in the tumor volume [57]. In a retrospective study with 102 patients, tumors with infiltrative growth pattern on MRI were associated with a lower overall and locoregional recurrence-free survival rates after chemoradiation [66].