Value of 3Tesla MRI in the preoperative staging of mid‐low rectal cancer and its impact on clinical strategies

Xu, Liping; Zhang, Chi; Zhang, Zhao-Yue; Qin, Qin; Sun, Xinchen

doi:10.1111/ajco.13368

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…To further confirm the clinical feasibility of synthetic MRI, we evaluated T stage and EMVI using synthetic T2WI and conventional T2WI. The diagnostic accuracy of EMVI by two observers was consistent with previous studies [ 25 – 27 ], as was the T stage [ 28 – 30 ]. Although the diagnostic accuracy with conventional T2WI was slightly higher than that with synthetic T2WI, the difference was not statistically significant.…”

Section: Discussionsupporting

confidence: 89%

A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

Liang

Wu³

et al. 2021

Insights Imaging

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Purpose To compare the imaging quality, T stage and extramural venous invasion (EMVI) evaluation between the conventional and synthetic T2-weighted imaging (T2WI), and to investigate the role of quantitative values obtained from synthetic magnetic resonance imaging (MRI) for assessing nodal staging in rectal cancer (RC). Methods Ninety-four patients with pathologically proven RC who underwent rectal MRI examinations including synthetic MRI were retrospectively recruited. The image quality of conventional and synthetic T2WI was compared regarding signal-to-noise ratio (SNR), contrast-to-noise (CNR), sharpness of the lesion edge, lesion conspicuity, absence of motion artifacts, and overall image quality. The accuracy of T stage and EMVI evaluation on conventional and synthetic T2WI were compared using the Mc-Nemar test. The quantitative T1, T2, and PD values were used to predict the nodal staging of MRI-evaluated node-negative RC. Results There were no statistically significant differences between conventional and synthetic T2WI in SNR, CNR, overall image quality, lesion conspicuity, and absence of motion artifacts (p = 0.058–0.978). There were no significant differences in the diagnostic accuracy of T stage and EMVI between conventional and synthetic T2WI from two observers (p = 0.375 and 0.625 for T stage; p = 0.625 and 0.219 for EMVI). The T2 value showed good diagnostic performance for predicting the nodal staging of RC with the area under the receiver operating characteristic, sensitivity, specificity, and accuracy of 0.854, 90.0%, 71.4%, and 80.3%, respectively. Conclusions Synthetic MRI may facilitate preoperative staging and EMVI evaluation of RC by providing synthetic T2WI and quantitative maps in one acquisition.

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Section: Discussionsupporting

confidence: 89%

A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

Liang

Wu³

et al. 2021

Insights Imaging

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“…This improvement is meaningful for clinical decision-making, taking into consideration neoadjuvant therapy in patients with the latter, known as locally advanced rectal cancer. Overstaging may lead to overtreatment for patients with T1-2 tumors and an elevated risk for therapy-related morbidity and mortality, while the underestimation might lead to lower possibility of local control (35). In the present study, the computed diffusion images avoided 7 cases with T3 tumors from overstaging, and 5 cases with T3 tumors from underestimation, providing higher accuracy, sensitivity, and the specificity in detecting T3 tumors.…”

Section: Discussionmentioning

confidence: 60%

Comparison of Computed and Acquired DWI in the Assessment of Rectal Cancer: Image Quality and Preoperative Staging

Xia

Wang

et al. 2022

Front. Oncol.

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ObjectiveThe aim of the study was to evaluate the computed diffusion-weighted images (DWI) in image quality and diagnostic performance of rectal cancer by comparing with the acquired DWI.MethodsA total of 103 consecutive patients with primary rectal cancer were enrolled in this study. All patients underwent two DWI sequences, namely, conventional acquisition with b = 0 and 1,000 s/mm2 (aDWIb1,000) and another with b = 0 and 700 s/mm2 on a 3.0T MR scanner (MAGNETOM Prisma; Siemens Healthcare, Germany). The images (b = 0 and 700 s/mm2) were used to compute the diffusion images with b value of 1,000 s/mm2 (cDWIb1,000). Qualitative and quantitative analysis of both computed and acquired DWI images was performed, namely, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and signal intensity ratio (SIR), and also diagnostic staging performance. Interclass correlation coefficients, weighted κ coefficient, Friedman test, Wilcoxon paired test, and McNemar or Fisher test were used for repeatability and comparison assessment.ResultsCompared with the aDWIb1,000 images, the cDWIb1,000 ones exhibited significant higher scores of subjective image quality (all P <0.050). SNR, SIR, and CNR of the cDWIb1,000 images were superior to those of the aDWIb1,000 ones (P <0.001). The overall diagnostic accuracy of computed images was higher than that of the aDWIb1,000 images in T stage (P <0.001), with markedly better sensitivity and specificity in distinguishing T1–2 tumors from the T3–4 ones (P <0.050).ConclusioncDWIb1,000 images from lower b values might be a useful alternative option and comparable to the acquired DWI, providing better image quality and diagnostic performance in preoperative rectal cancer staging.

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“…Regarding the accuracy of MRI, in the correct evaluation of the T descriptor of the TNM classification of rectal cancer, a very important role is played by the experience of the radiologist performing the investigation [42,43]. Thus, population studies have shown that the sensitivity of MRI in the correct evaluation of the T descriptor varies between 29 and 57% and the specificity varies between 50 and 83% [43][44][45][46][47]. These results are due, in part, to the experience of the examining physician and, on the other hand, to the difficulty of differentiating in some cases a stage T1 tumor from a stage T2 tumor.…”

Section: Local Staging In Rectal Cancer Using Mrimentioning

confidence: 99%

The Utility of Magnetic Resonance Imaging in the Multidisciplinary Treatment of Patients with Rectal Cancer

Hălmaciu¹,

Andrei²,

Russu³

et al. 2023

Current Topics in Colorectal Surgery

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Rectal cancer is one of the most common types of cancer in both men and women. In recent years, the importance of magnetic resonance imaging (MRI) has greatly increased in the multidisciplinary treatment of patients with rectal cancer. MRI has a particularly important role in the most accurate preoperative staging of these patients, both in terms of assessing the local invasion of the tumor and in terms of assessing the status of pelvic lymph nodes. Many patients with rectal cancer, especially those in the advanced stage of the disease, in the preoperative period undergo neoadjuvant radio chemotherapy. The evaluation of the clinical response of these patients to neoadjuvant therapy is of crucial importance both in terms of personalized treatment and in terms of their prognosis. In this regard, MRI has its clearly defined role at present in evaluating the efficacy of neoadjuvant therapy, as well as in postoperative follow-up.

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Value of 3Tesla MRI in the preoperative staging of mid‐low rectal cancer and its impact on clinical strategies

Cited by 7 publications

References 22 publications

A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

Comparison of Computed and Acquired DWI in the Assessment of Rectal Cancer: Image Quality and Preoperative Staging

The Utility of Magnetic Resonance Imaging in the Multidisciplinary Treatment of Patients with Rectal Cancer

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