Magnetic Resonance Imaging Evaluation of the Accuracy of Various Lymph Node Staging Criteria in Rectal Cancer: A Systematic Review and Meta-Analysis

Zhuang, Zixuan; Zhang, Yang; Wei, Mingtian; Yang, Xuyang; Wang, Ziqiang

doi:10.3389/fonc.2021.709070

Cited by 42 publications

(16 citation statements)

References 85 publications

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“…[16] However, MRI is less accurate for N staging than T staging, with sensitivity and specificity values ranging between 58% and 77% and 62% and 74%, respectively. [17][18][19] Multivariate logistic regression analysis revealed that the LN size and T stage were independent predictors of preoperative LN metastasis. Lim et al [20] showed that LN metastasis in rectal cancer is associated with the maximum short diameter of the LNs.…”

Section: Discussionmentioning

confidence: 99%

Use of a radiomics-clinical model based on magnetic diffusion-weighted imaging for preoperative prediction of lymph node metastasis in rectal cancer patients

Li,

Zeng,

2023

Medicine

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Rectal cancer is the eighth most prevalent malignancy worldwide with a 3.2% mortality rate and 3.9% incidence rate. Radiologists still have difficulty in correctly diagnosing lymph node metastases that have been suspected preoperatively. To assess the effectiveness of a model combining clinical and radiomics features for the preoperative prediction of lymph node metastasis in rectal cancer. We retrospectively analyzed data from 104 patients with rectal cancer. All patients were selected as samples for the training (n = 72) and validation cohorts (n = 32). Lymph nodes (LNs) in diffusion-weighted images were analyzed to obtain 842 radiomic characteristics, which were then used to draw the region of interest. Logistic regression, least absolute shrinkage and selection operator, and between-group and within-group correlation analyses were combined to establish the radiomic score (rad-score). Receiver operating characteristic curves were used to estimate the prediction accuracy of the model. A calibration curve was constructed to test the predictive ability of the model. A decision curve analysis was performed to analyze the model’s value in clinical application. The area under the curve for the radiomics-clinical, clinical, and radiomics models was 0.856, 0.810, and 0.781, respectively, in the training cohort and 0.880, 0.849, and 0.827, respectively, in the validation cohort. The calibration curve and DCA showed that the radiomics-clinical prediction model had good prediction accuracy, which was higher than that of the other models. The radiomics-clinical model showed a favorable predictive performance for the preoperative prediction of LN metastasis in patients with rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Use of a radiomics-clinical model based on magnetic diffusion-weighted imaging for preoperative prediction of lymph node metastasis in rectal cancer patients

Li,

Zeng,

2023

Medicine

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“…Seven of the eight patients studied had an initial N + tumor according to routine EUS and MRI. The initial lymph node involvement, especially the lymph node response after CT and RCT, is difficult to specify formally[ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Organ sparing to cure stage IV rectal cancer: A case report and review of literature

Meillat,

Garnier,

Palen

et al. 2023

World J Gastrointest Surg

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BACKGROUND Rectal sparing is an option for some rectal cancers with complete or good response after chemoradiotherapy (CRT); however, it has never been evaluated in patients with metastases. We assessed long-term outcomes of a rectal-sparing approach in a liver-first strategy for patients with rectal cancer with resectable liver metastases. CASE SUMMARY We examined patients who underwent an organ-sparing approach for rectal cancer with synchronous liver metastases using a liver-first strategy during 2010-2015 (n = 8). Patients received primary chemotherapy and pelvic CRT. Liver surgery was performed during the interval between CRT completion and rectal tumor re-evaluation. Clinical and oncological characteristics and long-term outcomes were assessed. All patients underwent liver metastatic resection with curative intent. The R0 rate was 100%. Six and two patients underwent local excision and a watch-and-wait (WW) approach, respectively. All patients had T3N1 tumors at diagnosis and had good clinical response after CRT. The median survival time was 60 (range, 14-127) mo. Three patients were disease free for 5, 8, and 10 years after the procedure. Five patients developed metastatic recurrence in the liver (n = 5) and/or lungs (n = 2). Only one patient developed local recurrence concurrent with metastatic recurrence 24 mo after the WW approach. Two patients died during follow-up. CONCLUSION The results suggest good local control in patients undergoing organ-sparing strategies for rectal cancer with synchronous liver metastasis. Prospective trials are required to validate these data and identify good candidates for these strategies.

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“…In daily practice, radiologists define lymphadenopathy in the upper abdomen primarily on size criteria, a short axis of > 10 mm. However, there are various reports that the size-criterion is not specific enough for various cancers 19 20 . Cross-sectional imaging could potentially assist in locating LNs to facilitate a more targeted approach for EUS-TA.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound in patients with resectable perihilar cholangiocarcinoma: impact on clinical decision-making

et al. 2022

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Introduction Accurate assessment of the lymph node (LN) status is crucial in resectable perihilar cholangiocarcinoma (pCCA) to prevent major surgery in patients with extraregional metastatic LN (MLN). This study investigates the added value of preoperative Endoscopic Ultrasound (EUS) with or without Tissue Acquisition (TA) for the detection of MLN in patients with resectable pCCA. Methods In this retrospective, multicenter cohort study, patients with potentially resectable pCCA who underwent EUS preoperatively between 2010-2020, were included. The clinical impact of EUS-TA was defined as the percentage of patients who did not undergo surgical resection due to MLN found with EUS-TA. Findings of cross-sectional imaging were compared with EUS-TA findings and surgery. Results EUS was performed in 141 patients, of whom 107 (76%) had suspicious LN on cross-sectional imaging. Surgical exploration was prevented in 20 (14%) patients because EUS-TA detected MLN, of which 17 (85%) were extraregional. Finally, 74 (52%) patients underwent surgical exploration followed by complete resection in 40 (28%). MLN were identified at definitive pathology in 24 (33%) patients, of which 9 (38%) were extraregional and 15 (63%) regional. Discussion EUS-TA has the promise to be of value in patients with potentially resectable pCCA based on preoperative cross-sectional imaging, regardless of lymphadenopathy at cross-sectional imaging. A prospective study in which a comprehensive EUS investigation with LN assessment and EUS-TA of LN is performed routinely should confirm this promise.

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Magnetic Resonance Imaging Evaluation of the Accuracy of Various Lymph Node Staging Criteria in Rectal Cancer: A Systematic Review and Meta-Analysis

Cited by 42 publications

References 85 publications

Use of a radiomics-clinical model based on magnetic diffusion-weighted imaging for preoperative prediction of lymph node metastasis in rectal cancer patients

Use of a radiomics-clinical model based on magnetic diffusion-weighted imaging for preoperative prediction of lymph node metastasis in rectal cancer patients

Organ sparing to cure stage IV rectal cancer: A case report and review of literature

Endoscopic ultrasound in patients with resectable perihilar cholangiocarcinoma: impact on clinical decision-making

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