Clinical relevance of morphologic MRI criteria for the assessment of lymph nodes in patients with rectal cancer.

Autor: Doyon F; Department of General Surgery, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. f.doyon@gmx.de., Attenberger UI; Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany., Dinter DJ; Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany., Schoenberg SO; Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany., Post S; Department of General Surgery, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany., Kienle P; Department of General Surgery, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Jazyk: angličtina
Zdroj: International journal of colorectal disease [Int J Colorectal Dis] 2015 Nov; Vol. 30 (11), pp. 1541-6. Date of Electronic Publication: 2015 Aug 11.
DOI: 10.1007/s00384-015-2339-y
Abstrakt: Aim: The aim of this study is the evaluation of lymph node staging by magnetic resonance imaging (MRI) within clinical routine in patients with rectal cancer.
Method: Routine MRI reports (3 T) of 65 consecutive patients with rectal cancer were retrospectively categorized in lymph node tumor positive or negative (mriN+; mriN0) and compared to the final histopathological results (pN+; pN0). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were calculated. The original MRI readings were then reanalyzed in order to identify the longest short-axis lymph node diameter for each patient. A receiver operating characteristic (ROC) curve was used to calculate a possible cutoff value for the short-axis lymph node diameter.
Results: Overall sensitivity was 94 %, specificity 13 %, NPV 86 %, PPV 28 %, and accuracy 34 %. The best accuracy could be calculated for a short-diameter cutoff of ≤5 mm (83 %); pN+ and pN0 groups were then significantly different (p < 0.0001).
Conclusion: In clinical routine, lymph node assessment in patients with rectal cancer through MRI tends to overstage malignant lymphadenopathy. A ≤5-mm cutoff value for the short-axis lymph node diameter of benign nodes is able to improve the accuracy and has potential to lower the risk of overstaging.
Databáze: MEDLINE
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