{"title":"Contrast-enhanced MRI and CT in evaluating treatment response for recurrent endometrial cancer: a retrospective case-control study.","authors":"Yan Chen, Xueling Wang","doi":"10.62347/TUED9082","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To compare the diagnostic performance of contrast-enhanced magnetic resonance imaging (CE-MRI) and computed tomography (CT) in evaluating treatment response for recurrent endometrial cancer (EC), and to assess the added value of integrating imaging findings with biomarker data.</p><p><strong>Methods: </strong>This retrospective case-control study included 217 patients with recurrent EC treated between January 2020 and December 2023. Patients were divided into response (n = 102) and non-response (n = 115) based on Response Evaluation Criteria in Solid Tumors (RECIST) (1.1). An internal validation cohort (n = 142) and an external cohort (n = 168) were also analyzed. Preoperative CE-MRI and CT scans were reviewed by experienced radiologists. Biomarker positivity rates - including estrogen receptor (ER), progesterone receptor (PR), cancer antigen 125 (CA125), cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), and ovarian cancer-related protein 1 (OVX1), were assessed. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate diagnostic performance, and an integrated model combining imaging and biomarkers was developed.</p><p><strong>Results: </strong>CE-MRI achieved an AUC of 0.864, sensitivity of 78.3%, and specificity of 86.3%, while CT showed an AUC of 0.854, sensitivity of 81.2%, and specificity of 83.4%. The integrated model improved performance with an AUC of 0.889, sensitivity of 94.3%, and specificity of 81.2%. Internal and external validation models yielded AUCs of 0.859 and 0.918, respectively.</p><p><strong>Conclusions: </strong>Both CE-MRI and CT are effective in assessing treatment response, with CE-MRI offering slightly superior specificity. Integration of imaging and biomarker data significantly enhances diagnostic accuracy, supporting its potential in optimizing individualized treatment strategies for recurrent EC.</p>","PeriodicalId":7437,"journal":{"name":"American journal of cancer research","volume":"15 5","pages":"2077-2096"},"PeriodicalIF":3.6000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163448/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of cancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.62347/TUED9082","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To compare the diagnostic performance of contrast-enhanced magnetic resonance imaging (CE-MRI) and computed tomography (CT) in evaluating treatment response for recurrent endometrial cancer (EC), and to assess the added value of integrating imaging findings with biomarker data.
Methods: This retrospective case-control study included 217 patients with recurrent EC treated between January 2020 and December 2023. Patients were divided into response (n = 102) and non-response (n = 115) based on Response Evaluation Criteria in Solid Tumors (RECIST) (1.1). An internal validation cohort (n = 142) and an external cohort (n = 168) were also analyzed. Preoperative CE-MRI and CT scans were reviewed by experienced radiologists. Biomarker positivity rates - including estrogen receptor (ER), progesterone receptor (PR), cancer antigen 125 (CA125), cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), and ovarian cancer-related protein 1 (OVX1), were assessed. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate diagnostic performance, and an integrated model combining imaging and biomarkers was developed.
Results: CE-MRI achieved an AUC of 0.864, sensitivity of 78.3%, and specificity of 86.3%, while CT showed an AUC of 0.854, sensitivity of 81.2%, and specificity of 83.4%. The integrated model improved performance with an AUC of 0.889, sensitivity of 94.3%, and specificity of 81.2%. Internal and external validation models yielded AUCs of 0.859 and 0.918, respectively.
Conclusions: Both CE-MRI and CT are effective in assessing treatment response, with CE-MRI offering slightly superior specificity. Integration of imaging and biomarker data significantly enhances diagnostic accuracy, supporting its potential in optimizing individualized treatment strategies for recurrent EC.
期刊介绍:
The American Journal of Cancer Research (AJCR) (ISSN 2156-6976), is an independent open access, online only journal to facilitate rapid dissemination of novel discoveries in basic science and treatment of cancer. It was founded by a group of scientists for cancer research and clinical academic oncologists from around the world, who are devoted to the promotion and advancement of our understanding of the cancer and its treatment. The scope of AJCR is intended to encompass that of multi-disciplinary researchers from any scientific discipline where the primary focus of the research is to increase and integrate knowledge about etiology and molecular mechanisms of carcinogenesis with the ultimate aim of advancing the cure and prevention of this increasingly devastating disease. To achieve these aims AJCR will publish review articles, original articles and new techniques in cancer research and therapy. It will also publish hypothesis, case reports and letter to the editor. Unlike most other open access online journals, AJCR will keep most of the traditional features of paper print that we are all familiar with, such as continuous volume, issue numbers, as well as continuous page numbers to retain our comfortable familiarity towards an academic journal.