Diagnostic performance of MRI for staging peritoneal metastases in patients with colorectal cancer after neoadjuvant chemotherapy.

Autor: Rijsemus CJV; Department of Radiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands; Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands; GROW School for Oncology and Developmental Biology - University of Maastricht, Maastricht, the Netherlands. Electronic address: c.rijsemus@nki.nl., Kok NFM; Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands., Aalbers AGJ; Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands., Buffart TE; Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands., Fijneman RJA; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands., Snaebjornsson P; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands., Engbersen MP; Department of Radiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands; GROW School for Oncology and Developmental Biology - University of Maastricht, Maastricht, the Netherlands., Lambregts DMJ; Department of Radiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands., Beets-Tan RGH; Department of Radiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands; GROW School for Oncology and Developmental Biology - University of Maastricht, Maastricht, the Netherlands., Lahaye MJ; Department of Radiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2022 Apr; Vol. 149, pp. 110225. Date of Electronic Publication: 2022 Feb 19.
DOI: 10.1016/j.ejrad.2022.110225
Abstrakt: Introduction: MRI improves the selection of patients with colorectal cancer (CRC) and peritoneal metastases (PM) for cytoreductive surgery by accurately assessing the extent of PM reflected as the peritoneal cancer index (PCI). The performance of MRI after neoadjuvant chemotherapy (NACT) for staging PM, however is unknown. The purpose of this study was to determine whether MRI could also accurately determine the PCI after NACT.
Materials and Methods: This was a single-centre, retrospective study of patients with PM from CRC or appendiceal origin who received NACT followed by diffusion-weighted (DW)-MRI and surgery from January 2016 to February 2021. Two radiologists assessed the PCI on restaging DW-MRI (mriPCI). The reference standard was the surgical PCI (sPCI). The main outcome was the diagnostic performance of restaging DW-MRI in predicting whether patients were eligible for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), defined as a PCI < 21 with metastases on resectable locations. If CRS-HIPEC was performed, the resected peritoneal lesions were assessed and correlated with the final pathological PCI (pPCI).
Results: Thirty-three patients were included. Both readers correctly detected all 23 patients with resectable disease. Eight out of ten patients with unresectable disease during staging surgery were detected by both readers with MRI. The intraclass correlation (ICC) between both readers was excellent (0⋅87 (95% CI: 0⋅75 to 0⋅93)). The ICC between pPCI and mriPCI was 0⋅74 (0⋅49-0⋅88) and 0⋅82 (0⋅66-0⋅91) for the 2 readers. Surgical PCI (sPCI) had a similar correlation as mriPCI with pPCI 0⋅82 (0⋅62- 0⋅92)) and 0⋅81 (0⋅57-0⋅92)).
Conclusion: DW-MRI is a promising tool to reassess the peritoneal cancer index after neoadjuvant chemotherapy.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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