The influence of endorectal filling on rectal cancer staging with MRI

Stijns, Rutger C.H.; Scheenen, Tom W. J.; Wilt, Johannes H. W. de; Fütterer, Jurgen J.

doi:10.1259/bjr.20180205

Cited by 16 publications

(4 citation statements)

References 21 publications

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“…A large discrepancy was seen between the number of lymph nodes detected. Differences in numbers of detected mesorectal lymph nodes may be reader-dependent based on the experience of the radiologist or on the time that was invested in lymph node evaluation [32]. The evaluation time for each of the two MRI readers was not measured, but the time spent could partly account for the difference.…”

Section: Tablementioning

confidence: 99%

USPIO-enhanced MRI of lymph nodes in rectal cancer: A node-to-node comparison with histopathology

Stijns

Philips

Nagtegaal

et al. 2021

European Journal of Radiology

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To evaluate the initial results of predicting lymph node metastasis in rectal cancer patients detected invivo with USPIO-enhanced MRI at 3 T compared on a node-to-node basis with histopathology. Methods: Ten rectal cancer patients of all clinical stages were prospectively included for an in-vivo 0.85 mm 3 isotropic 3D MRI after infusion of Ferumoxtran-10. The surgical specimens were examined ex-vivo with an 0.29 mm 3 isotropic MRI examination. Two radiologists evaluated in-vivo MR images with a classification scheme to predict lymph node status. Ex-vivo MRI was used for MR-guided pathology and served as a key link between invivo MRI and final histopathology for the node-to-node analysis. Results: 138 lymph nodes were detected by reader 1 and 255 by reader 2 (p = 0.005) on in-vivo MRI with a median size of 2.6 and 2.4 mm, respectively. Lymph nodes were classified with substantial inter-reader agreement (κ = 0.73). Node-to-node comparison was possible for 55 lymph nodes (median size 3.2 mm; range 1.2-12.3), of which 6 were metastatic on pathology. Low true-positive rates (3/26, 11 % for both readers) and high true negative rates were achieved (14/17, 82 %; 19/22, 86 %). Pathological re-evaluations of 20 lymph nodes with high signal intensity on USPIO-enhanced MRI without lymph node metastases (false positives) did not reveal tumor metastasis but showed benign lymph node tissue with reactive follicles. Conclusions: High resolution MRI visualizes a large number of mesorectal lymph nodes. USPIO-enhanced MRI was not accurate for characterizing small benign versus small tumoral lymph nodes in rectal cancer patients. Suspicious nodes on in-vivo MRI occur as inflammatory as well as metastatic nodes.

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Section: Tablementioning

confidence: 99%

USPIO-enhanced MRI of lymph nodes in rectal cancer: A node-to-node comparison with histopathology

Stijns

Philips

Nagtegaal

et al. 2021

European Journal of Radiology

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“…Studies ( 13 – 16 ) have reported filling the rectum for better visualization of lesions and evaluation of tumor penetration on MRI. In contrast, other studies ( 37 – 39 ) advised against distending the rectum due to possible undesirable effects on the distance between the rectal lesion and MRF. Therefore, the mesorectal area or volume was not included in this study due to instability.…”

Section: Discussionmentioning

confidence: 98%

An MRI-based pelvimetry nomogram for predicting surgical difficulty of transabdominal resection in patients with middle and low rectal cancer

et al. 2022

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ObjectiveThe current work aimed to develop a nomogram comprised of MRI-based pelvimetry and clinical factors for predicting the difficulty of rectal surgery for middle and low rectal cancer (RC).MethodsConsecutive mid to low RC cases who underwent transabdominal resection between June 2020 and August 2021 were retrospectively enrolled. Univariable and multivariable logistic regression analyses were carried out for identifying factors (clinical factors and MRI-based pelvimetry parameters) independently associated with the difficulty level of rectal surgery. A nomogram model was established with the selected parameters for predicting the probability of high surgical difficulty. The predictive ability of the nomogram model was assessed by the receiver operating characteristic (ROC) curve and decision curve analysis (DCA).ResultsA total of 122 cases were included. BMI (OR = 1.269, p = 0.006), pelvic inlet (OR = 1.057, p = 0.024) and intertuberous distance (OR = 0.938, p = 0.001) independently predicted surgical difficulty level in multivariate logistic regression analysis. The nomogram model combining these predictors had an area under the ROC curve (AUC) of 0.801 (95% CI: 0.719–0.868) for the prediction of a high level of surgical difficulty. The DCA suggested that using the nomogram to predict surgical difficulty provided a clinical benefit.ConclusionsThe nomogram model is feasible for predicting the difficulty level of rectal surgery, utilizing MRI-based pelvimetry parameters and clinical factors in mid to low RC cases.

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“…There is a controversy about the benefits of rectal ultrasound filling in the diagnostic setting. This is especially due to the possibility that the rectal distention caused by the ultrasound filling might artificially shorten the distance of the tumor to the mesorectal fascia or increase the distance of the tumor from the dentate line (Slater, Halligan et al 2006, Stijns, Scheenen et al 2018. Moreover, the parts of the tumor that define risk feature such as infiltration depth or extramural venous invasion are extramural and not affected by higher contrast in the rectum.…”

Section: Discussionmentioning

confidence: 99%

Impact of endorectal filling on interobserver variability of MRI based rectal primary tumor delineation

Russo¹,

Nachbar²,

Barry³

et al. 2023

Clinical and Translational Radiation Oncology

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The influence of endorectal filling on rectal cancer staging with MRI

Cited by 16 publications

References 21 publications

USPIO-enhanced MRI of lymph nodes in rectal cancer: A node-to-node comparison with histopathology

USPIO-enhanced MRI of lymph nodes in rectal cancer: A node-to-node comparison with histopathology

An MRI-based pelvimetry nomogram for predicting surgical difficulty of transabdominal resection in patients with middle and low rectal cancer

Impact of endorectal filling on interobserver variability of MRI based rectal primary tumor delineation

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