Accuracy of thin section magnetic resonance using phased-array pelvic coil in predicting the T-staging of rectal cancer

Poon, F. W.; McDonald, Alec; Anderson, John H.; Duthie, Fraser; Rodger, C.; McCurrach, G.; McKee, Ruth F.; Horgan, Paul G.; Chong, D.; Finlay, I. G.

doi:10.1016/j.ejrad.2004.03.011

Cited by 32 publications

(22 citation statements)

References 23 publications

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“…Moderate-high accuracy rates (74%-100%) for T staging were reported using high spatial resolution thin-section MRI (11,(14)(15)(16). Despite significant improvement in the thin-section MRI group, our accuracy rates for T stage were on the lower side compared to the literature, mainly due to two factors.…”

Section: Discussioncontrasting

confidence: 51%

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Accuracy of MR imaging in preoperative staging of rectal cancer

Peker¹

2016

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Aim: In this study we aimed to evaluate the accuracy of preoperative rectal cancer staging in our center, using 1.0 Tesla Magnetic resonance imaging (MRI) with phased-array coils and determine if the results can be improved by adopting thin-section MRI techniques.Materal and Methods: Eighty-four patients with biopsy proven rectal cancer were prospectively evaluated by MRI using either the standard (8 mm sections in all planes) or the thin-section protocol (additional 5 mm sections in oblique axial plane perpendicular to the long axis of the tumor). Patients undergoing surgery with or without neoadjuvant therapy (standard MRI, n=15 and thin-section MRI, n=22) were included in the analysis. TNM stage, circumferential resection margin (CRM) and adjacent organ involvement were compared with histopathologic findings.Results: In the thin-section group, estimation of tumor stage was 59% accurate, showing fair agreement with histopathology (κ=0.38, p<0.05); sensitivity and specificity rates were 100% and 59% for T2 and 47% and 100% for T3 stages. In the standard group estimation of T stage was only 40% accurate, showing no significant agreement with histopathology. The most frequent staging error was under-staging of borderline pT3 tumors in both groups. Accuracy, sensitivity and specificity of positive CRM were 67%, 67% and 95% for thin-section group and 50%, 100% and 93% for standard group, respectively; agreement with histopathology was significant only for the thin-section group (κ=0.61; p<0.05). Accuracy of nodal status was 77% in the thin-section group (κ=0.51; p<0.05) and 87% in the standard group (κ=0.75; p<0.05).Conclusion: Thin-section MRI techniques can be used to improve tumor staging and positive CRM predictions even with low field magnet systems.Key Words: Magnetic Resonance Imaging, Rectal Cancer, Tumor Staging Amaç: Bu çalışmada merkezimizde 1.0 Tesla Magnetik Rezonans (MR) cihazı ile faz dizilimli koil kullanarak preoperatif rektum kanseri evrelemesinin doğruluğunun değerlendirilmesi ve ince kesit MR teknikleri kullanarak sonuçların iyileştirilebilir olup olmadığının belirlenmesi amaçlanmıştır.Gereç ve Yöntem: Biyopsi ile rektum kanseri tanısı kanıtlanmış 84 hasta standart (tüm planlarda 8 mm kalınlı-ğında kesitler) ya da ince kesit protokol (ek olarak tümörün uzun aksına dik 5 mm kalınlığında kesitler) kullanıla-rak Manyetik rezonans görüntüleme (MRG) ile prospektif olarak değerlendirilmiştir. Neoadjuvan tedavi alarak ya da almadan (standart MRG, n=15 ve ince kesit MRG, n=22) opere edilen hastalar analize dahil edilmiştir. TNM evrelemesi, çevresel rezeksiyon sınırı ve komşu organ tutulumu histopatolojik bulgular ile karşılaştırılmıştır. Bulgular: İnce kesit grubunda, tümör evresi histopatoloji (κ=0.38, p<0.05) ile %59 uyumlu, hassasiyet ve özgüllük ise T2 evresi için %100 ve %59, T3 evresi için %47 ve %100 doğruluktadır. Standart grupta T evresi histopatoloji ile anlamlı bir uyum göstermemekle birlikte yalnızca %40 doğruluktadır. İki grupta en sık evreleme hatası, sınırda pT3 tümörlerin düşük evrelenme...

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Section: Discussioncontrasting

confidence: 51%

“…In the literature most T2/T3 staging errors are seen as over-staging of pT2 as opposed to under-staging of pT3 (14)(15)(16)(17). This is because fibrotic spiculations can not be easily distinguished from extramural extensions containing tumor cells.…”

Section: Discussionmentioning

confidence: 98%

Accuracy of MR imaging in preoperative staging of rectal cancer

Peker¹

2016

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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“…DISCUSSIOn MR imaging with ap elvic coil is widely used for preoperative staging of rectal cancer.W eobtained a sensitivity of 88%, aspecificity of 80%and adiagnostic accuracy of 85% in the local staging of rectal cancer by using ap elvic phased-array coil and ab lack lumen filling technique. In arecent study Poon et al reached adiagnostic accuracy of 74% in a42-patient study (15). On the other hand, Hadfield et al attained an accuracy of only 55%, but they used at hickness of up to an 8m ms lice with a2m mg ap (16).…”

Section: Resultsmentioning

confidence: 99%

“…The Kappa value κ was calculated for inter-observer agreement, and the level of agreement was interpreted via commonly-used guidelines (15). Statistical analysis was conducted using SPSS 11.0.…”

Section: Methodsmentioning

confidence: 99%

Local Staging of Rectal Cancer Using the Black Lumen Magnetic Resonance Imaging Technique

et al. 2008

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Background and Aims: the treatment of rectal cancer is comprised of surgery and possible adjuvant therapy depending on the stage of the tumour.t his prospective study evaluates the accuracy of magnetic resonance imaging (mri) in the preoperative staging of rectal cancer using an endorectal and intravenous contrast.Materials and Methods: 37 consecutive patients with rectal cancer were imaged using am ixture of ferumoxsil and methylcellulose endorectally,a nd ag adolinium contrast intravenously.3 3t umours were resected and 4t umours were considered unresectable during operation. the images were reviewed for local staging of the tumours. atumour confined to the rectal wall was classified as an egative finding and at umour invading through muscularis propria as ap ositive finding. the results were correlated with the histopathologic tstage (n =33), or the clinical status (n =4).Results and Conclusions: of 37 cases, 20 (51 %) were true positive, and 11 (28%) were true negative. there were 3 false negative and 3 false positive cases. the sensitivity was 87%, specificity 79%, and diagnostic accuracy 84%. for the non-contrast images the figures were 78%, 79% and 78%, respectively.We consider black lumen magnetic resonance imaging to be auseful method for preoperative local staging of rectal cancer.

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“…1). Overstaging of pT2 tumors (38-62%) and understaging of pT3 tumors (5-18%) has been reported [13,14]. Although at present the differentiation between T2 and early T3 tumors has little clinical impact, in future when individual-based tailored treatment will be performed based on selection by imaging, this differentiation could become important.…”

Section: Locoregional Stagingmentioning

confidence: 99%

Role of Preoperative Local and Distant Staging in Rectal Cancer

Engelen

Beets

2007

Oncol Res Treat

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Preoperative imaging in rectal cancer is very important, as accurate staging determines optimal treatment strategy. In this review, imaging modalities for locoregional and distant staging in rectal cancer are discussed. For local staging, superficial tumors are best staged using endorectal US (EUS), as EUS is the most accurate modality for assessment of tumor ingrowth into the rectal wall layers. The more advanced tumors are best imaged using MRI, because MRI accurately predicts the distance from tumor to mesorectal fascia, and thus the circumferential resection margin (CRM), as well as possible invasion into surrounding organs. For the prediction of the nodal status none of the three imaging modalities - EUS, MRI and CT - can be reliably used for clinical decisionmaking. Only MRI using lymph node specific contrast (such as ultrasmall paramagnetic iron oxide-enhanced MRI) seems promising for the detection of nodal disease. For the detection of distant metastases transabdominal ultrasound and chest X-ray are used as a primary screening tool. However, for the high prevalence group (stage III) both methods are insufficiently sensitive, and CT of the chest plus abdomen is preferred.

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Accuracy of thin section magnetic resonance using phased-array pelvic coil in predicting the T-staging of rectal cancer

Cited by 32 publications

References 23 publications

Accuracy of MR imaging in preoperative staging of rectal cancer

Accuracy of MR imaging in preoperative staging of rectal cancer

Local Staging of Rectal Cancer Using the Black Lumen Magnetic Resonance Imaging Technique

Role of Preoperative Local and Distant Staging in Rectal Cancer

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