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Release: April 7, 1999

UI researchers study MRI as predictor of treatment success in cervical cancer

IOWA CITY, Iowa -- University of Iowa researchers are studying how magnetic resonance imaging (MRI) can help physicians choose effective treatments for women with advanced cervical cancer.

A $700,000 National Institutes of Health grant supports a five-year clinical study led by Nina A. Mayr, M.D., UI associate professor of radiation oncology.

"To improve treatment outcomes for women with cervical cancer, physicians need to predict as accurately as possible how well therapy will work for each patient," Mayr said. "Our study looks at how the MRI can provide a more accurate prediction of how effective radiation and chemotherapy treatment will be for each patient."

Mayr said a predictor is important because physicians need to use more intensive therapies for women whose cervical cancers will likely not respond to standard treatment and, conversely, to avoid unnecessary complications from intensified therapies in those women who will do well with standard therapy.

The five-year survival rate for women with stage II or III cervical cancer is only about 65 percent. That statistic fuels the researchers' effort to improve treatment success, Mayr said. She added that a treatment success predictor is "hard to come by."

"Most tests can't tell the physician about treatment effectiveness until the cancer has already recurred." Mayr said. "But you need to know this information before or very early in the treatment course. Then the physician can adjust the treatment plan and give the patient the best chance. If you don't use the best possible therapy the first time around, the chance of successful treatment is often lost by the time the tumor recurs."

The MRI can give results within about 30 minutes, and the procedure is easy for the patient, Mayr said. The precise images reveal how much blood and oxygen is reaching a tumor.

"Tumor blood supply is a critical factor for the success of therapy," Mayr explained. "The better the blood supply, the more likely the tumor will respond to radiation and chemotherapy."

Mayr's predictor method adapts a novel MRI technique called perfusion imaging that was originally developed by William T. Yuh, M.D., UI professor of radiology and co-principal investigator of this study. He first used the technique to assess the blood supply of stroke patients.

Mayr believes the cervical cancer MRI predictor study is the first of its kind. She said early results of the study of Iowa women show that the method is "promising and can predict treatment outcome very early." But she cautioned that the results are preliminary and require more study.

The complete study will determine how the MRI can help physicians identify patients with cervical cancer who will not respond to conventional therapy.

"Ultimately, we hope to use the MRI findings to decide whether to change therapy up front for a patient to improve her chances of successful treatment," Mayr said.

Patients in the clinical trial will receive a diagnostic MRI usually just before beginning a combined radiation and chemotherapy course of treatment. After two weeks of therapy, they will have a second MRI to determine whether the treatment is working. A third MRI is done after five weeks.

The UI clinical study will be open for another four and a half years to women who have stage IB2, II, III or IVA cervical cancer. Physicians or patients who are interested in the study should call Mayr at (319) 356-4884.