LEESBURG, Va -- March 3, 2009 -- Pretreatment magnetic resonance imaging (MRI) and positron emission tomography (PET) with computed tomography (CT) for cervical cancer may direct more women to optimal therapy choices, and spare many women potential long-term morbidity and complications from trimodality therapy, according to a study published in the March issue of the American Journal of Roentgenology.
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 stage IB cervical cancer.
"The goal of pretreatment imaging is to identify these patients noninvasively, spare them surgery and have them treated with chemoradiation alone," said lead author Pari Pandharipande, MD, Institute for Technology Assessment, Boston, Massachusetts.
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 most patients of trimodality therapy (95%).
"Pretreatment imaging can triage patients to optimal primary treatment choices that minimise 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."
"Our study shows how pretreatment imaging may improve chances of correctly receiving surgery or chemoradiation instead of both."
"MRI and PET/CT are expensive, but long-term consequences of trimodality therapy can severely affect long-term quality of life and are also expensive," she continued. "Further study of these long-term consequences is needed to more precisely consider the cost implications of upfront MRI and PET/CT."
SOURCE: American Roentgen Ray Society
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