Characterising and quantifying intratumour heterogeneity in cervical cancer with intravoxel incoherent motion diffusion-weighted MRI.

Dr Lee, Elaine Yuen Phin   (Principal Investigator (PI))

Professor Ngan Hextan Yuen Sheung   (Co-Investigator)

Dr Hui Sai Kam   (Co-Investigator)

Dr Chan Lawrence, Wing-chi   (Co-Investigator)

36

2016-09-01

570115

Characterising and quantifying intratumour heterogeneity in cervical cancer with intravoxel incoherent motion diffusion-weighted MRI.

Cervical cancer, Histogram analysis, Intratumour heterogeneity, IVIM

Imaging,Cancer

Biology and Medicine (M)

17119916

General Research Fund (GRF)

2016

Completed

1 To quantify the degree of intratumour heterogeneity in LACC by IVIM histogram analysis Hypothesis: IVIM histogram analysis derived imaging biomarkers are feasible and can potentially reflect intratumour heterogeneity in both the cellular and microcirculatory tumour environment of LACC. Rationale: The unchecked proliferation and disorganised angiogenesis in LACC are hallmarks of solid tumour growth. These biological properties of LACC occur in a non-uniform way resulting in intratumour heterogeneity. Approach: Whole-tumour volumetric evaluation of LACC using IVIM histogram analysis to determine mean, median, skewness, kurtosis and percentiles as measures of tumour heterogeneity. Impact: The information generated will allow us to quantify the degree of intratumour heterogeneity and will help to improve our understanding of the intratumour heterogeneity within the LACC tumour environment with reference to its proliferative and angiogenic potential without related problems due to sampling error of small tissue samples. 2 To determine the relationship between the degree of intratumour heterogeneity as determined by IVIM histogram analysis, and the clinicopathologic features and treatment outcome of LACC. Hypothesis: IVIM histogram analysis of intratumour heterogeneity correlates with known adverse clinicopathologic characteristics of LACC (for example, adenocarcinoma histology, high FIGO stage, large tumour size, and presence of lymphatic spread) and poor treatment outcome. Rationale: Heterogeneous tumour is prognostic of adverse tumour biology and is partly responsible for the development of tumour resistance to therapy. It is usually characterised by necrosis and poor perfusion, providing an unfavourable tumour environment for selecting the survival of the more resistant clones. Approach: The mean, median, skewness, kurtosis and percentiles values generated from IVIM histogram analysis will be correlated with the histology, FIGO stage, tumour size, lymphatic spread and treatment outcome of LACC. Impact: This study may provide the basis and direction for further research in treatment response assessment and monitoring of the changes in intratumour heterogeneity throughout CRT. Ultimately, the role of intratumour heterogeneity in disease prognosis can be further studied.