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Yan Q, Yan X, Yang X, Li S, Song J. The use of PET/MRI in radiotherapy. Insights Imaging 2024; 15:63. [PMID: 38411742 PMCID: PMC10899128 DOI: 10.1186/s13244-024-01627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/21/2024] [Indexed: 02/28/2024] Open
Abstract
Positron emission tomography/magnetic resonance imaging (PET/MRI) is a hybrid imaging technique that quantitatively combines the metabolic and functional data from positron emission tomography (PET) with anatomical and physiological information from MRI. As PET/MRI technology has advanced, its applications in cancer care have expanded. Recent studies have demonstrated that PET/MRI provides unique advantages in the field of radiotherapy and has become invaluable in guiding precision radiotherapy techniques. This review discusses the rationale and clinical evidence supporting the use of PET/MRI for radiation positioning, target delineation, efficacy evaluation, and patient surveillance.Critical relevance statement This article critically assesses the transformative role of PET/MRI in advancing precision radiotherapy, providing essential insights into improved radiation positioning, target delineation, efficacy evaluation, and patient surveillance in clinical radiology practice.Key points• The emergence of PET/MRI will be a key bridge for precise radiotherapy.• PET/MRI has unique advantages in the whole process of radiotherapy.• New tracers and nanoparticle probes will broaden the use of PET/MRI in radiation.• PET/MRI will be utilized more frequently for radiotherapy.
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Affiliation(s)
- Qi Yan
- Cancer Center, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Taiyuan, China
| | - Xia Yan
- Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory for Translational Nuclear Medicine and Precision Protection, Taiyuan, China
| | - Xin Yang
- Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
| | - Jianbo Song
- Cancer Center, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Taiyuan, China.
- Shanxi Provincial Key Laboratory for Translational Nuclear Medicine and Precision Protection, Taiyuan, China.
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Kilcoyne A, Gottumukkala RV, Kang SK, Akin EA, Hauck C, Hindman NM, Huang C, Khanna N, Paspulati R, Rauch GM, Said T, Shinagare AB, Stein EB, Venkatesan AM, Maturen KE. ACR Appropriateness Criteria® Staging and Follow-up of Primary Vaginal Cancer. J Am Coll Radiol 2021; 18:S442-S455. [PMID: 34794599 DOI: 10.1016/j.jacr.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
Primary vaginal cancer is rare, comprising 1% to 2% of gynecologic malignancies and 20% of all malignancies involving the vagina. More frequently, the vagina is involved secondarily by direct invasion from malignancies originating in adjacent organs or by metastases from other pelvic or extrapelvic primary malignancies. Data on the use of imaging in vaginal cancer are sparse. Insights are derived from the study of imaging in cervical cancer and have reasonable generalizability to vaginal cancer due to similar tumor biology. Given the trend toward definitive chemoradiation for both cancers in all but early stage lesions, principles of postchemoradiation tumor response evaluation are largely analogous. Accordingly, many of the recommendations outlined here are informed by principles translated from the literature on cervical cancer. For pretreatment assessment of local tumor burden and in the case of recurrent vaginal cancer, MRI is the preferred imaging modality. PET/CT has demonstrated utility for the detection of nodal metastatic and unexpected distant metastatic disease. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Aoife Kilcoyne
- Panel Vice Chair, Massachusetts General Hospital, Boston, Massachusetts.
| | | | - Stella K Kang
- Panel Chair, New York University Medical Center, New York, New York
| | - Esma A Akin
- The George Washington University Medical Center, Washington, District of Columbia; ABNM Board Member; and IAC Board Member
| | - Carlin Hauck
- Sutter Medical Center Sacramento, Sacramento, California
| | - Nicole M Hindman
- Associate Chair, Diversity & Health Equity, MR Safety Officer, and Director, Female Pelvic Imaging, New York University Medical Center, New York, New York; and Fellow Rep., Board of the Society for Advanced Body Imaging
| | - Chenchan Huang
- New York University Langone Medical Center, New York, New York
| | - Namita Khanna
- Emory University, Atlanta, Georgia; Society of Gynecologic Oncology
| | | | - Gaiane M Rauch
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tamer Said
- Program Director, Family Medicine Residency Program, University Hospitals Cleveland Medical Center, Cleveland, Ohio; and Primary care physician
| | - Atul B Shinagare
- Chief, Abdominal Imaging and Intervention, Brigham & Women's Hospital Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Erica B Stein
- Director, Body CT, University of Michigan Medical Center, Ann Arbor, Michigan
| | | | - Katherine E Maturen
- Specialty Chair, University of Michigan, Ann Arbor, Michigan; and Member, Society of Abdominal Radiology Board of Directors
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Diagnostic Accuracy of 18F-FDG-PET/CT and MRI in Predicting the Tumor Response in Locally Advanced Cervical Carcinoma Treated by Chemoradiotherapy: A Meta-Analysis. CONTRAST MEDIA & MOLECULAR IMAGING 2021; 2021:8874990. [PMID: 33746650 PMCID: PMC7943297 DOI: 10.1155/2021/8874990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/17/2021] [Accepted: 02/20/2021] [Indexed: 01/19/2023]
Abstract
Objective The aim of this meta-analysis was to compare the diagnostic accuracy of 18F-FDG-PET/CT and MRI in predicting the tumor response in locally advanced cervical carcinoma (LACC) treated by chemoradiotherapy (CRT). Method This meta-analysis has been performed according to PRISMA guidelines. Systematic searches were conducted using PubMed and Embase databases for articles published from January 1, 2010, to January 1, 2020. By using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, the reviewers assessed the methodological quality scores of the selected studies. We analyzed the sensitivity, specificity, and accuracy of two diagnostic methods using Meta-DiSc 1.4 and Stata 15. Results An overall of 15 studies including 1132 patients were included. Sensitivities of PET/CT and MRI were 83.5% and 82.7%, while the corresponding rates for specificities were 77.8% and 68.4%, respectively. The DOR, PLR, and NLR for MRI were 15.140, 2.92, and 22.6. PET/CT had a DOR of 25.21. The PLR and NLR for PET/CT were 4.13 and 0.215, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of residual tumor were 86% and 95%, respectively. The corresponding rates for MRI were 73% and 96%, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of tumor metastases were 97% and 99%, while the corresponding rates for MRI were 31% and 98%, respectively. Conclusion 18F-FDG PET/CT seemed to have a better overall diagnostic accuracy in the evaluation of treatment response to chemoradiotherapy in LACC patients. MRI showed a really poor sensitivity in the detection of metastases, and PET/CT performed significantly better. However, the difference between these two methods in the detection of residual disease was not significant. More studies are needed to be conducted in order to approve that 18F-FDG PET/CT can be a standard option to assess the treatment response.
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Tumor Size at Magnetic Resonance Imaging Association With Lymph Node Metastasis and Lymphovascular Space Invasion in Resectable Cervical Cancer: A Multicenter Evaluation of Surgical Specimens. Int J Gynecol Cancer 2019; 28:1545-1552. [PMID: 30044321 PMCID: PMC6166705 DOI: 10.1097/igc.0000000000001327] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective To determine whether gross tumor volume (GTV) and the maximum diameter of resectable cervical cancer at magnetic resonance imaging (MRI) could predict lymph node metastasis (LNM) and lymphovascular space invasion (LVSI). Materials and Methods A total of 315 consecutive patients with cervical cancer were retrospectively identified. Gross tumor volume and the maximum diameter of tumor were evaluated on MRI. Univariate and multivariate logistic regression analyses were performed to determine whether tumor size could predict LNM and LVSI. Cutoffs of GTV, maximum diameter, and the International Federation of Gynecology and Obstetrics (FIGO) classification of tumor were first investigated in 255 patients (group A) and then validated in an independent cohort of 60 patients (group B) using area under the receiver operating characteristic curve (AUC) analysis for predicting the presence of LNM and LVSI. Results Univariate analysis showed that GTV and the maximum diameter of tumor could predict LNM and LVSI (all P < 0.0001). Multivariate analyses indicated GTV as an independent risk factor of LNM and LVSI (all P < 0.0001). In group A, GTV, the maximum diameter, and the FIGO stage could identify LNM (AUC, 0.813, 0.741, and 0.69, respectively) and LVSI (AUC, 0.806, 0.751, and 0.684, respectively). In group B, GTV, the maximum diameter, and the FIGO stage could help identify LNM (AUC, 0.902, 0.825, and 0.759, respectively) and LVSI (AUC, 0.771, 0.748, and 0.700, respectively). Conclusions Gross tumor volume and the maximum diameter of resectable cervical cancer at MRI demonstrated capability in predicting LNM and LVSI, which were more accurate than FIGO stage.
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Chakrabarti B, Pal SK, Sepai HM, Roy SB, Kar SK, Lahiri A, Das S, Bala A. Clinical and dosimetric consequences of imperfect applicator insertion in cervical cancer brachytherapy. J Contemp Brachytherapy 2018; 10:321-336. [PMID: 30237816 PMCID: PMC6142650 DOI: 10.5114/jcb.2018.77954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 07/31/2018] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This study analyzes clinical consequences and dosimetric variations after imperfect brachytherapy insertions. It examines treatment decisions after such insertions in patients having difficult anatomy, which leads to good subsequent insertions with acceptable dose volume parameters. MATERIAL AND METHODS We reviewed images of all insertions performed during last one year and sorted faulty ones out. Clinical outcome was assessed, analyzing original treatment records. Repeat three-dimensional planning using identical dose-optimization-technique compared their dosimetry. Statistical analysis using SPSS®-Statistics-software included Fisher's-exact-test to analyze predisposing factors for faulty insertions and predictive factors for subsequent satisfactory insertion. Friedman test was used to compare dose-volume-effects of normalization. RESULTS Eighteen of 292 brachytherapy plans revealed imperfect insertions, including thirteen perforations (4.5%). Lack of pre-planning, obstructing mass, narrow vagina, acute anteversion of uterus, and multi-parity were significant (p ≤ 0.05) predisposing factors for atypical insertions. Satisfactory optimization was possible after correcting acute anteflexion or positioning tandem in retroverted direction in uncorrectable retroverted uterus. Dose normalization at point A shifted optimized dose from contoured volume to point of normalization, often undesirably. This difference, however, was statistically not significant (p = 0.121). In patients having obstructing mass, subsequent insertions were perfect, and dose volume parameters were acceptable only when full prescribed dose was delivered to at least 60% volume of the mass after a faulty insertion (p < 0.001). CONCLUSIONS Pre-planning by imaging is suggested in all cases of brachytherapy. Insertion of adequate length of tandem aligned to uterine axis is warranted for adequate tumor coverage. Whenever detected, acute anteflexion and mobile retroversion should be corrected. Tandem inserted in retroverted direction in uncorrectable retroverted uterus generates acceptable dose volume parameters. In cases with obstructive cervical mass, good subsequent insertion is possible with acceptable dose volume parameters, if planned dose can be delivered to its 60% volume.
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Affiliation(s)
- Bikramjit Chakrabarti
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
| | - Suparna Kanti Pal
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
| | - Harris Mahammad Sepai
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
| | - Somapriya Basu Roy
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
| | - Sanjay Kr Kar
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
| | - Annesha Lahiri
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
| | - Sounik Das
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
| | - Amit Bala
- Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Kernani Memorial Hospital, Kolkata, India
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Off-line magnetic resonance imaging navigation of cervix cancer brachytherapy in patients with risk factors for uterine perforation. J Contemp Brachytherapy 2018; 9:519-526. [PMID: 29441095 PMCID: PMC5807993 DOI: 10.5114/jcb.2017.71912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/06/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose There are no reports on pre-insertion identification of cervix cancer patients at risk for uterine perforation during brachytherapy (BT). Our aim was to assess the incidence of risk factors in our patient cohort, and assess feasibility of a novel technique of magnetic resonance imaging (MRI)-guided navigation for applicator insertion (NAI) in high-risk cases. Material and methods All patients with locally advanced cervical cancer, treated with image guided adaptive BT at our department between October 2013 and June 2017 were considered for analysis. Tumor characteristics on initial MRI (MRIinitial), pre-BT MRI (MRIpre-BT), and BT MRI (MRIBT) were assessed. Frequency of risk factors (age above 60 years, retroverted/retroflected uterus, tumor necrosis, non-visible cervical orifice, distorted cervical canal) was recorded. Patients with two or more factors underwent MRI guided NAI. Time needed for NAI was estimated and procedure feasibility score assigned using a three-tiered scoring system. Results Twenty-seven patients (98 insertions) were included. Mean tumor volume was 70.2 (± 47.9), 17.8 (± 18.9), and 10.3 (± 9.1) cm3 on MRIinitial, MRIpre-BT, and MRIBT1, respectively (p < 0.05). In 16 (59%) cases, ≥ 1 perforation risk factor was found on MRIpre-BT: distorted canal in 12 (44%), necrosis in 9 (33%), retroverted/retroflected uterus in 8 (30%) cases. Nine (33%) patients had ≥ 2 risk factors and underwent MRI guided NAI. Additional time to perform NAI was estimated at 105 minutes, and feasibility score was 1 in all cases. There were no cases of uterine perforation. Conclusions Using pre-insertion MRI, we found ≥ 2 risk factors for uterine perforation in 1/3 of patients. Off-line MRI navigation was feasible and enabled non-complicated insertion in all cases. Further studies with larger sample size are warranted to assess its clinical efficacy.
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Mongula JE, Bakers FCH, Vöö S, Lutgens L, van Gorp T, Kruitwagen RFPM, Slangen BFM. Positron emission tomography-magnetic resonance imaging (PET-MRI) for response assessment after radiation therapy of cervical carcinoma: a pilot study. EJNMMI Res 2018; 8:1. [PMID: 29292485 PMCID: PMC5748389 DOI: 10.1186/s13550-017-0352-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/14/2017] [Indexed: 01/05/2023] Open
Abstract
Background Advanced stage cervical cancer is primarily treated by radiotherapy. Local tumor control is a prerequisite for cure. Imaging after treatment is controversial. Positron emission tomography (PET) combined with computer tomography (PET-CT) shows great promise for detecting metastases. On the other hand, magnetic resonance imaging (MRI) is superior in depicting anatomical details. The combination of PET-MRI could result in more accurate evaluation of cervical cancer treatment outcome. The aim of this pilot study is to share our initial experience with PET-MRI in the evaluation of treatment response in cervical cancer after radiation treatment. Methods Ten patients with cervical carcinoma (FIGO ≥IB2) were prospectively evaluated. Eleven weeks (median; range 8–15 weeks) after radiation therapy, treatment response was evaluated by PET-MRI. The PET, MRI, and combined PET-MRI images were evaluated for the presence of local residual tumor and metastasis. Diagnostic performance was assessed by area under the receiver operator characteristic (ROC) curve for evaluation of local residual tumor. The readers were blinded for outcome data. Local residual disease, metastasis, diagnostic confidence, and change of opinion were scored on a 5-point Likert scale. The reference standard consisted of pathology and/or follow-up according to the clinical guidelines. Results Three out of ten patients had local residual abnormalities suggestive for tumor residue after radiation treatment. The availability of both PET and MRI resulted in an increase in diagnostic confidence in 80–90% of all patients. Change of opinion was observed in 70% and change of policy in 50%, especially in the group with residual tumor. The diagnostic accuracy increased significantly for the radiologist if PET-MRI was combined (AUC .54 versus .83). Conclusions PET-MRI shows promise for evaluation of treatment response after radiation for cervical cancer, especially increasing diagnostic confidence, while potentially increasing diagnostic performance.
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Affiliation(s)
- J E Mongula
- Department of Obstetrics and Gynecology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Postbus 5800, 6202, Maastricht, AZ, The Netherlands.
| | - F C H Bakers
- Department of Radiology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - S Vöö
- Department of Nuclear Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L Lutgens
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - T van Gorp
- Department of Obstetrics and Gynecology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Postbus 5800, 6202, Maastricht, AZ, The Netherlands
| | - R F P M Kruitwagen
- Department of Obstetrics and Gynecology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Postbus 5800, 6202, Maastricht, AZ, The Netherlands
| | - B F M Slangen
- Department of Obstetrics and Gynecology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Postbus 5800, 6202, Maastricht, AZ, The Netherlands
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Focal boost to residual gross tumor volume in brachytherapy for cervical cancer—A feasibility study. Brachytherapy 2018; 17:181-186. [DOI: 10.1016/j.brachy.2017.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 09/04/2017] [Accepted: 09/18/2017] [Indexed: 11/18/2022]
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Yan S, Li X, Jin Q, Yuan J. MicroRNA-145 sensitizes cervical cancer cells to low-dose irradiation by downregulating OCT4 expression. Exp Ther Med 2016; 12:3130-3136. [PMID: 27882128 DOI: 10.3892/etm.2016.3731] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/23/2016] [Indexed: 12/13/2022] Open
Abstract
Poor elucidation of the mechanisms involved in regulating the radiosensitivity of cancers prevents the extensive application of low-dose radiotherapy in clinical settings. The present study was conducted to investigate the role of microRNA-145 (miR-145) in the modulation of cervical cancer cell radiosensitivity, as well as to identify the underlying target of miR-145 during this process. Cervical cancer tera cells were initially exposed to doses of radiation between 1 and 6 Gy before the assessments of the cell viability and apoptosis rate. Irradiation at dose of 1 Gy was screened as optimum dose and used in subsequent experiments. A dual luciferase reporter assay was performed to demonstrate that octamer-binding transcription factor 4 (OCT4) is a target of miR-145 in cervical cancer. Consequently, OCT4 was suggested to be a target of miR-145, as a dual luciferase vector that was ligated to a fragment corresponding to the predicted target site of miR-145 in OCT4 3'-UTR showed an 83% reduction in fluorescence. Following exposure to 1 Gy irradiation, tera cells transfected with miR-145 mimics, which showed downregulation of OCT4 and cyclin D1, had lower cell viability and cell migration rate and higher apoptosis rate compared to non-transfected cells. However, the co-transfection of miR-145 mimics and OCT4 expression vector restored OCT4 and cyclin D1 expression levels and made no significant difference in terms of cell viability, cell migration rate and apoptosis rate. The present results indicate that miR-145 increases the radiosensitivity of cervical cancer cells by silencing OCT4, that cyclin D1 is putatively under the positive regulation of OCT4 and mediates miR-145 function.
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Affiliation(s)
- Siqi Yan
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Xiangjun Li
- Department of Oncology, The Second People's Hospital, Changsha, Hunan 410000, P.R. China
| | - Qiao Jin
- Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, P.R. China
| | - Jun Yuan
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
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Soliman AS, Owrangi A, Ravi A, Song WY. Metal artefacts in MRI-guided brachytherapy of cervical cancer. J Contemp Brachytherapy 2016; 8:363-9. [PMID: 27648092 PMCID: PMC5018526 DOI: 10.5114/jcb.2016.61817] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/28/2016] [Indexed: 11/29/2022] Open
Abstract
The importance of assessing the metal-induced artefacts in magnetic resonance imaging (MRI)-guided brachytherapy is growing along with the increasing interest of integrating MRI into the treatment procedure of cervical cancer. Examples of metal objects in use include intracavitary cervical applicators and interstitial needles. The induced artefacts increase the uncertainties in the clinical workflow and can be a potential obstacle for the accurate delivery of the treatment. Overcoming this problem necessitates a good understanding of its originating sources. Several efforts are recorded in the literature to quantify the extent of such artefacts, in phantoms and in clinical practice. Here, we elaborate on the origin of metal-induced artefacts in the light of brachytherapy applications, while summarizing recent efforts that have been made to assess and overcome the induced distortions.
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Affiliation(s)
- Abraam S Soliman
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Physical Sciences Platform, Sunnybrook Research Institute, Toronto
| | - Amir Owrangi
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Ananth Ravi
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Physical Sciences Platform, Sunnybrook Research Institute, Toronto; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - William Y Song
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Physical Sciences Platform, Sunnybrook Research Institute, Toronto; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
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