MRI-based nomogram analysis: recognition of anterior peritoneal reflection and its relationship to rectal cancers
Autor: | Jianping Lu, Xiaolu Ma, Minjie Wang, Shaoting Zhang, Fangying Chen, Xianhua Gao, Fu Shen, Guanyu Yu |
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Rok vydání: | 2021 |
Předmět: |
Male
Colorectal cancer Intraclass correlation Anal Canal Nomogram Body Mass Index 030218 nuclear medicine & medical imaging 0302 clinical medicine Medicine Rectal cancer Aged 80 and over medicine.diagnostic_test Age Factors Seminal Vesicles Colonoscopy Middle Aged Tumor Burden medicine.anatomical_structure lcsh:R855-855.5 030220 oncology & carcinogenesis Female Peritoneum Research Article Adult animal structures lcsh:Medical technology Urinary Bladder Rectum 03 medical and health sciences Sex Factors Magnetic resonance imaging Humans Radiology Nuclear Medicine and imaging Aged Neoplasm Staging Retrospective Studies Receiver operating characteristic Rectal Neoplasms business.industry Uterus Anterior peritoneal reflection medicine.disease Confidence interval Nomograms Logistic Models ROC Curve Feasibility Studies T-stage business Nuclear medicine |
Zdroj: | BMC Medical Imaging, Vol 21, Iss 1, Pp 1-9 (2021) BMC Medical Imaging |
ISSN: | 1471-2342 |
Popis: | Background This study is aimed to explore the factors influencing the visualization of the anterior peritoneal reflection (APR) and evaluated the feasibility of measuring the distance from the anal verge to APR (AV-APR), the tumor height on MRI and the accuracy of determining the tumor location with regard to APR. Methods We retrospectively analyzed 110 patients with rectal cancer. A univariate and multivariate logistic regression was performed to identify the independent factors (age, sex, T stage, the degree of bladder filling, pelvic effusion, intraoperative tumor location, BMI, uterine orientation, the distance from seminal vesicle/uterus to rectum) associated with the visualization of the APR on MRI. The nomogram diagram and receiver operating characteristic curve (ROC curve) were established. Intraclass correlation coefficient (ICC) was used to evaluate the consistency of the distance of AV-APR. The Pearson correlation coefficient was used to characterize the agreement between measurements of the tumor height by colonoscopy and MRI. The Kappa statistics was used to evaluate the value of MRI in the diagnosis of the tumor location with regard to the APR. Results Multivariate logistic regression showed that BMI (P = 0.031, odds ratio, OR = 1.197), pelvic effusion (P = 0.020, OR = 7.107) and the distance from seminal vesicle/uterus to the rectum (P = 0.001, OR = 3.622) were correlated with the visualization of APR. The cut-off point of BMI and the distance from seminal vesicle/uterus to the rectum is 25.845 kg/m2 and 1.15 cm. The area under curve (AUC) (95% Confidence Interval, 95% CI) of the combined model is 0.840 (0.750–0.930). The favorable calibration of the nomogram showed a non-significant Hosmer–Lemeshow test statistic (P = 0.195). The ICC value (95% CI) of the distance of AV-APR measured by two radiologists was 0.981 (0.969–0.989). The height measured by MRI and colonoscopy were correlated with each other (r = 0.699, P Conclusions BMI, pelvic effusion, and the distance from seminal vesicle/uterus to rectum could affect the visualization of APR on MRI. Also, it’s feasible to measure the distance of AV-APR, the tumor height, and to evaluate the tumor location with regard to APR using MRI. |
Databáze: | OpenAIRE |
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