Value of MRI and diffusion-weighted MRI for the diagnosis of locally recurrent rectal cancer.

Autor: Lambregts DM, Cappendijk VC, Maas M, Beets GL, Beets-Tan RG, Lambregts, Doenja M J, Cappendijk, Vincent C, Maas, Monique, Beets, Geerard L, Beets-Tan, Regina G H
Zdroj: European Radiology; Jun2011, Vol. 21 Issue 6, p1250-1258, 9p
Abstrakt: Objectives: To evaluate the accuracy of standard MRI, diffusion-weighted MRI (DWI) and fusion images for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence.Methods: Forty-two patients with a clinical suspicion of recurrence underwent 1.5-T MRI consisting of standard T2-weighted FSE (3 planes) and an axial DWI (b0,500,1000). Two readers (R1,R2) independently scored the likelihood of recurrence; [1] on standard MRI, [2] on standard MRI+DWI, and [3] on T2-weighted+DWI fusion images.Results: 19/42 patients had a local recurrence. R1 achieved an area under the ROC-curve (AUC) of 0.99, sensitivity 100% and specificity 83% on standard MRI versus 0.98, 100% and 91% after addition of DWI (p = 0.78). For R2 these figures were 0.87, 84% and 74% on standard MRI and 0.91, 89% and 83% with DWI (p = 0.09). Fusion images did not significantly improve the performance. Interobserver agreement was κ0.69 for standard MRI, κ0.82 for standard MRI+DWI and κ0.84 for the fusion images.Conclusions: MRI is accurate for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence. Addition of DWI does not significantly improve its performance. However, with DWI specificity and interobserver agreement increase. Fusion images do not improve accuracy. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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