Pretherapeutic MRI for decision-making regarding selective neoadjuvant radiochemotherapy for rectal carcinoma: interim analysis of a multicentric prospective observational study
| Autor: | Reinhard Ruppert, Christoph Andreas Maurer, Susanne Merkel, Paul Hermanek, Theodor Junginger, Katja Oberholzer, Henry Ptok, Joachim Stassburg |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Sensitivity and Specificity Decision Support Techniques Mesorectal fascia Risk Factors Germany Rectal carcinoma medicine Prevalence Cutoff Humans Radiology Nuclear Medicine and imaging Aged Aged 80 and over business.industry Rectal Neoplasms Reproducibility of Results Chemoradiotherapy Adjuvant Middle Aged Interim analysis Prognosis Predictive value Neoadjuvant Therapy Treatment Outcome Circumferential resection margin Observational study Female Cutoff point Radiology business |
| Zdroj: | Journal of magnetic resonance imaging : JMRI. 37(5) |
| ISSN: | 1522-2586 |
| Popis: | Purpose: To study the accuracy of different cutoffs for an involved circumferential resection margin (CRM) compared with T and N categories measured by MRI as basis for selective application of neoadjuvant radiochemotherapy (nRCT) in rectal carcinoma. Materials and Methods: In a prospective multicenter observational study involving 153 primarily operated patients, the preoperative results of MRI with pathohistological findings of resected specimens were compared. Results: For a cutoff of ≤1 mm for involvement of the CRM, the accuracy of preoperative MRI was 90.9% (139/153). The negative predictive value was 98.5% (134/136). The four participating departments did not differ significantly. For a cutoff of >2 mm and >5 mm, the rates of false-positive findings increased significantly from 5% to 12% and 35% with a decrease in accuracy to 82% and 62%, respectively. In contrast, the accuracy in predicting T (69.3%) and N categories (61.4%) was much lower. Conclusion: The indication for nRCT should be based on the determination of the minimal distance of the tumor from mesorectal fascia with a cutoff point of >1 mm as measured by MRI. J. Magn. Reson. Imaging 2013;37:1122–1128. © 2013 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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