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MRI and PET/CT improve cervical cancer patient's chances for optimal treatment
Date:3/3/2009

Pretreatment MRI and PET/CT for cervical cancer may direct more women to optimal therapy choices and spare many women potential long-term morbidity and complications of trimodality therapy (surgery followed by chemoradiation), according to a study performed at the Institute for Technology Assessment in Boston, MA.

An interdisciplinary team of investigators developed a decision-analytic model to determine the value of pretreatment imaging with MRI and/or PET/CT in patients with FIGO Stage IB cervical cancer. "Stage IB cervical cancer, in the absence of pre-treatment imaging, is treated with surgery. As surgery cannot completely resect the cancer in many of these patients, they receive post-surgical chemoradiation, i.e. trimodality therapy," said Pari Pandharipande, MD, lead author of the study. "The goal of pre-treatment imaging is to identify these patients noninvasively, spare them surgery and have them treated with chemoradiation alone," she said. Study results showed that while imaging does not improve survival, PET/CT resulted in the highest percentage of patients receiving correct primary therapy (89%) and use of both MRI and PET/CT spared the most patients of trimodality therapy (95%).

"Pretreatment imaging can triage patients to optimal primary treatment choices that minimize the risk of long-term complications and morbidity while preserving chances for survival," said Dr. Pandharipande. "Because both over- and underestimation of disease extent can result in adverse patient outcomes, determining the extent of disease accurately up front is critical. For example, when patients are subjected to pelvic surgery, and then are radiated in the same operative field, complication rates can increase by a substantial percentage, as compared to if they were simply treated with surgery alone or chemoradiation alone. Our study shows how pre-treatment imaging may improve chances of correctly receiving surgery or chemoradiation instead of both," sa
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Contact: Heather Curry
hcurry@arrs.org
703-858-4304
American Roentgen Ray Society
Source:Eurekalert

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