MRI for Restaging Locally Advanced Rectal Cancer: Detailed Analysis of Discrepancies With the Pathologic Reference Standard

AJR. American Journal of Roentgenology
Xiaoxuan JiaNan Hong

Abstract

OBJECTIVE. The purpose of this study was to analyze causes of discrepancies between restaging MRI and pathologic findings in the assessment of morphologic indicators of tumor response in patients with rectal cancer who have undergone neoadjuvant treatment. MATERIALS AND METHODS. MRI and pathologic data from 57 consecutively registered patients who underwent neoadjuvant treatment and total mesorectal excision between August 2015 and July 2018 were retrospectively analyzed. The sensitivity and specificity of restaging MRI in determining tumor regression grade, T category, N category, circumferential resection margin, and extramural vascular invasion were calculated with pathologic results as the reference standard. One-by-one comparisons between MRI and pathologic findings were conducted to identify causes of discrepancies. RESULTS. The sensitivity of MRI in determining tumor regression grades 3-5 was 77.1%; T3 and T4 category, 100.0%; node-positive disease, 75.0%; circumferential resection margin, 87.5%; and extramural vascular invasion, 91.7%. The specificity values were 72.7%, 62.5%, 70.7%, 85.7%, and 64.4%. Overstaging was mainly caused by misinterpretation of fibrotic areas as residual tumor. Inflammatory cell infiltration c...Continue Reading

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Citations

Jun 12, 2020·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Seong Ho ParkUNKNOWN Korean Society of Abdominal Radiology Study Group for Rectal Cancer
Mar 3, 2021·Diseases of the Colon and Rectum·Lindsey C F de NesUNKNOWN Dutch ColoRectal Audit Group
Apr 17, 2021·Seminars in Roentgenology·Krista Elise Suarez-WeissMukesh G Harisinghani
Jun 17, 2021·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Jong Keon JangJin Cheon Kim
Jul 11, 2021·Clinical Radiology·R J GoiffonM G Harisinghani

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