Tumor hypoxia is a major cause of treatment resistance and poor survival in locally-advanced cervical
carcinoma (LACC). It has been suggested that K trans and v e maps derived by dynamic contrast-enhanced magnetic resonance imaging can provide information on the
oxygen supply and oxygen consumption of
tumors, but it is not clear whether and how these maps can be combined to identify tumor hypoxia. The aim of the current study was to find the optimal strategy for calculating hypoxic fraction and predicting survival from K trans and v e maps in cervical
carcinoma. K trans and v e maps of 98
tumors of four patient-derived xenograft models of cervical
carcinoma as well as 80 patients with LACC were investigated. Hypoxic fraction calculated by using K trans maps correlated strongly (P < 0.0001) to hypoxic fraction assessed with immunohistochemistry using
pimonidazole as a
hypoxia marker and was associated with disease-free and overall survival in LACC patients. Maps of v e did not provide information on hypoxic fraction and patient outcome, and combinations of K trans and v e were not superior to K trans alone for calculating hypoxic fraction. These observations imply that K trans maps reflect
oxygen supply and may be used to identify
hypoxia and predict outcome in cervical
carcinoma, whereas v e is a poor parameter of oxygen consumption and does not provide information on
tumor oxygenation status.