Diagnostic performance of magnetic resonance to assess treatment response after neoadjuvant therapy in patients with locally advanced rectal cancer
| Autor: | Ulysses Ribeiro Junior, Natally Horvat, Marcos Roberto de Menezes, Sergio Carlos Nahas, Carlos Frederico Sparapan Marques, Gerson Montoya Cama, Ivan Cecconello, Rodrigo Lautert de Azambuja, Caio Sergio Rizkallah Nahas |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Urology medicine.medical_treatment Sensitivity and Specificity Internal medicine Medicine Humans Radiology Nuclear Medicine and imaging Pathological Neoadjuvant therapy Aged Neoplasm Staging Tumor Regression Grade Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Rectal Neoplasms Gastroenterology Margins of Excision Magnetic resonance imaging Chemoradiotherapy Hepatology Middle Aged medicine.disease Total mesorectal excision Magnetic Resonance Imaging Neoadjuvant Therapy Histopathology Female business Nuclear medicine |
| Zdroj: | Abdominal radiology (New York). 44(11) |
| ISSN: | 2366-0058 |
| Popis: | Our study aimed to evaluate the diagnostic performance of rectal magnetic resonance imaging (MRI) for local restaging in patients with non-metastatic locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (CRT) using surgical histopathology of total mesorectal excision as the reference standard. Ninety-five patients with LARC who underwent rectal MRI after CRT between January 2014 and December 2016 were included. Accuracy, sensitivity, specificity, positive, and negative predictive value for local staging regarding T-stage, N-stage, circumferential resection margin, and MRI tumor regression grade (ymriTRG) were calculated, and inter-test agreements were assessed. 22/95 (23.2%) patients had radiological complete response (rCR), whereas 20/95 (21.1%) had pathological complete response (pCR). Among the patients with pCR, 11/20 (55%) had rCR. Fair agreement was demonstrated between ymriTRG and pathological TRG (ypTRG) (κ = 0.255). The sensitivity and specificity for detection of pCR were 61.1% (95% CI 35.7–82.7) and 89.6% (95% CI 80.6–95.4). For the detection of ypTRG grades 1 and 2, the corresponding values were 67.2% (95% CI 54.3–78.4) and 51.6 (95% CI 33.1–69.8). The accuracy of ymriTRG was 24.2% (95% CI 15.6–32.8). Inter-test agreement in TRG between MRI and pathology was overall fair (κ = 0.255) and slight (κ = 0.179), if TRG 1 + 2. Qualitative assessment on MRI for diagnosing pCR showed moderate sensitivity and high specificity, whereas the diagnosis of TRG had moderate sensitivity and low specificity with slight to fair inter-test agreement when compared with pathological specimens. |
| Databáze: | OpenAIRE |
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