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
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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