Abstract

Purpose

To evaluate the targetability of late-stage cervical cancer by magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-induced hyperthermia (HT) as an adjuvant to radiation therapy (RT).

Methods

Seventy-nine cervical cancer patients (stage IIIB–IVA) who received RT with lesions visible on positron emission tomography-computed tomography (PET-CT) were retrospectively analyzed for targetability using a commercially-available HT-capable MRgHIFU system. Targetability was assessed for both primary targets and/or any metastatic lymph nodes using both posterior (supine) and anterior (prone) patient setups relative to the transducer. Thirty-four different angles of rotation along subjects’ longitudinal axis were analyzed. Targetability was categorized as: (1) Targetable with/without minimal intervention; (2) Not targetable. To determine if any factors could be used for prospective screening of patients, potential associations between demographic/anatomical factors and targetability were analyzed.

Results

72.15% primary tumors and 33.96% metastatic lymph nodes were targetable from at least one angle. 49.37% and 39.24% of primary tumors could be targeted with patient laying in supine and prone positions, respectively. 25°–30° rotation and 0° rotation had the highest rate of the posterior and anterior targetability, respectively. The ventral depth of the tumor and its distance to the coccyx were statistically correlated with the anterior and posterior targetability, respectively.

Conclusion

Most late-stage cervical cancer primaries were targetable by MRgHIFU HT requiring either no/minimal intervention. A rotation of 0° or 25°–30° relative to the transducer might benefit anterior and posterior targetability, respectively. Certain demographic/anatomic parameters might be useful in screening patients for treatability.

中文翻译：

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磁共振引导的高强度聚焦超声（MRgHIFU）介导的高温（HT）对接受放射治疗的患者的宫颈癌靶向性

摘要

目的

通过磁共振引导的高强度聚焦超声（MRgHIFU）诱导的体温过高（HT）作为放疗（RT）的辅助药物，评估晚期宫颈癌的靶向性。

方法

使用市售的具有HT功能的MRgHIFU系统回顾性分析了79例接受RT治疗并在正电子发射断层扫描计算机断层扫描（PET-CT）上可见病变的宫颈癌患者（IIIB–IVA期）。使用相对于换能器的后（仰卧）和前（俯卧）患者设置，评估主要靶标和/或任何转移性淋巴结的可靶向性。分析了沿受试者纵轴的34个不同的旋转角度。可定位性分类为：（1）在有/无最少干预的情况下可定位；（2）不可定位。为了确定是否有任何因素可用于对患者进行前瞻性筛查，分析了人口统计学/解剖学因素与可靶向性之间的潜在关联。

结果

从至少一个角度可靶向72.15％的原发肿瘤和33.96％的转移性淋巴结。仰卧位和俯卧位的患者可分别靶向原发肿瘤的49.37％和39.24％。25°–30°旋转和0°旋转分别具有最高的后定向性和前定向性。肿瘤的腹侧深度及其与尾骨的距离在统计学上分别与前，后靶向性相关。

结论

MRgHIFU HT可以靶向大多数晚期宫颈癌原发灶，而无需/只需进行最小干预。相对于换能器的0°或25°–30°旋转可能分别有利于前向和后向可瞄准性。某些人口统计学/解剖学参数可能有助于筛查患者的可治疗性。