Primary and post-chemoradiotherapy staging using MRI in rectal cancer: the role of diffusion imaging in the assessment of perirectal infiltration

被引:9
作者
Fornell-Perez, Roberto [1 ]
Perez-Alonso, Esteban [1 ,2 ]
Porcel-de-Peralta, Gabriela [3 ]
Duran-Castellon, Alfonso [3 ]
Vivas-Escalona, Valentina [3 ]
Aranda-Sanchez, Joel [3 ]
Carmen Gonzalez-Dominguez, Maria [3 ]
Rubio-Garcia, Jano [3 ]
Aleman-Flores, Patricia [3 ]
Lozano-Rodriguez, Alvaro [3 ]
Elena Orihuela-de-la-Cal, Maria [3 ]
Francisco Loro-Ferrer, Juan [1 ]
机构
[1] Univ Las Palmas Gran Canaria, Fac Med, Clin Sci Dept, Paseo Blas Cabrera Felipe S-N, Palmas De Gran Canaria 35016, Spain
[2] Complejo Hosp Univ Insular Materno Infantil, Dept Gen Surg, Ave Maritima S-N, Palmas De Gran Canaria 35016, Spain
[3] Complejo Hosp Univ Insular Materno Infantil, Dept Radiol, Ave Maritima S-N, Palmas De Gran Canaria 35016, Spain
关键词
Magnetic resonance imaging; Rectal neoplasms; Neoadjuvant chemoradiotherapy; Diffusion-weighted imaging; TOTAL MESORECTAL EXCISION; WEIGHTED MRI; ACCURACY; CHEMORADIATION; THERAPY; TUMOR; RECURRENCE; MANAGEMENT;
D O I
10.1007/s00261-019-02139-4
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose To analyze changes in MRI diagnostic accuracy in main rectal tumor (T) evaluation resulting from the use of diffusion-weighted imaging (DWI), according to the degree of experience of the radiologist. Methods This is a cross-sectional study of a database including one hundred 1.5 T MRI records (2011-2016) from patients with biopsy-proven rectal cancer, including primary staging and post-chemoradiotherapy follow-up. All cases were individually blindedly reviewed by ten radiologists: three experienced in rectal cancer, three specialized in other areas, and four residents. Each case was assessed twice to detect perirectal infiltration: first, evaluating just high-resolution T2-weighted sequences (HRT2w); second, evaluation of DWI plus HRT2w sequences. Results were pooled by experience, calculating accuracy (area under ROC curve), sensitivity and specificity, predictive values, likelihood ratios, and overstaging/understaging. Histology of surgical specimens provided the reference standard. Results DWI significantly improved specificity by experienced radiologists in primary staging (63.2% to 75.9%) and, to a lesser extent, positive likelihood ratio (2.06 to 2.87); minimal changes were observed post-chemoradiotherapy, with a slight decrease of accuracy (0.657 to 0.626). Inexperienced radiologists showed a similar pattern, but with slight enhancement post-chemoradiotherapy (accuracy 0.604 to 0.621). Residents experienced small changes, with increased sensitivity/decreased specificity in both primary (69% to 72%/67.2% to 64.7%) and post-chemoradiotherapy (68.1% to 73.6%/47.3% to 44.6%) staging. Conclusions Adding DWI to HRT2w significantly improved specificity for the detection of perirectal infiltration at primary staging by experienced radiologists and also by inexperienced ones, although to a lesser extent. In the post-neoadjuvant treatment subgroup, only minimal changes were observed.
引用
收藏
页码:3674 / 3682
页数:9
相关论文
共 38 条
  • [1] Rectal carcinoma: MRI with histologic correlation before and after chemoradiation therapy
    Allen, Steven D.
    Padhani, Anwar R.
    Dzik-Jurasz, Andrzej S.
    Glynne-Jones, Robert
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 2007, 188 (02) : 442 - 451
  • [2] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting
    Beets-Tan, Regina G. H.
    Lambregts, Doenja M. J.
    Maas, Monique
    Bipat, Shandra
    Barbaro, Brunella
    Curvo-Semedo, Luis
    Fenlon, Helen M.
    Gollub, Marc J.
    Gourtsoyianni, Sofia
    Halligan, Steve
    Hoeffel, Christine
    Kim, Seung Ho
    Laghi, Andrea
    Maier, Andrea
    Rafaelsen, Soren R.
    Stoker, Jaap
    Taylor, Stuart A.
    Torkzad, Michael R.
    Blomqvist, Lennart
    [J]. EUROPEAN RADIOLOGY, 2018, 28 (04) : 1465 - 1475
  • [3] MRI for evaluation of treatment response in rectal cancer
    Blazic, Ivana M.
    Campbell, Naomi M.
    Gollub, Marc J.
    [J]. BRITISH JOURNAL OF RADIOLOGY, 2016, 89 (1064)
  • [4] Radiologic and Pathological Correlation of Staging of Rectal Cancer with 3 Tesla Magnetic Resonance Imaging
    Chatterjee, Parangama
    Eapen, Anu
    Perakath, Benjamin
    Singh, Ashish
    [J]. CANADIAN ASSOCIATION OF RADIOLOGISTS JOURNAL-JOURNAL DE L ASSOCIATION CANADIENNE DES RADIOLOGISTES, 2011, 62 (03): : 215 - 222
  • [5] Value of Diffusion-Weighted and Gadolinium-Enhanced MRI for the Diagnosis of Pelvic Recurrence From Colorectal Cancer
    Colosio, Alban
    Soyer, Philippe
    Rousset, Pascal
    Barbe, Coralie
    Nguyen, Francis
    Bouche, Olivier
    Hoeffel, Christine
    [J]. JOURNAL OF MAGNETIC RESONANCE IMAGING, 2014, 40 (02) : 306 - 313
  • [6] Rectal Cancer: Assessment of Complete Response to Preoperative Combined Radiation Therapy with Chemotherapy-Conventional MR Volumetry versus Diffusion-weighted MR Imaging
    Curvo-Semedo, Lus
    Lambregts, Doenja M. J.
    Maas, Monique
    Thywissen, Thomas
    Mehsen, Rana T.
    Lammering, Guido
    Beets, Geerard L.
    Caseiro-Alves, Filipe
    Beets-Tan, Regina G. H.
    [J]. RADIOLOGY, 2011, 260 (03) : 734 - 743
  • [7] How reliable is current imaging in restaging rectal cancer after neoadjuvant therapy?
    De Nardi, Paola
    Carvello, Michele
    [J]. WORLD JOURNAL OF GASTROENTEROLOGY, 2013, 19 (36) : 5964 - 5972
  • [8] Transanal endoscopic microsurgical excision of rectal tumors:: Indications and results
    Demartines, N
    von Flüe, MO
    Harder, FH
    [J]. WORLD JOURNAL OF SURGERY, 2001, 25 (07) : 870 - 875
  • [9] Magnetic Resonance Imaging of Rectal Cancer
    Dewhurst, Catherine E.
    Mortele, Koenraad J.
    [J]. RADIOLOGIC CLINICS OF NORTH AMERICA, 2013, 51 (01) : 121 - +
  • [10] Edge S.B., 2011, AJCC CANC STAGING MA, V7th, P143