DCE, ADC and 18FDG PET/CT radiomics parameters, obtained simultaneously before, early during and midway during ongoing radiation/chemotherapy correlate with tumor response and particularly mortality, and can serve as early predictors of treatment outcome in advanced cervical cancer. Longitudinal development of functional heterogeneity may be a sensitive measure reflecting responsiveness of individual tumors to a specific cytotoxic treatment regimen. Particularly the persistence of skewness of the dynamic contrast enhancement within the tumor volume predicted cancer mortality. Functional radiomics assessment may help address the unmet need for a patient- and treatment-specific early indicator of tumor responsiveness and survival.
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