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Accuracy of MRI for Predicting the Circumferential Resection Margin, Mesorectal Fascia Invasion, and Tumor Response to Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

Cited 44 time in Web of Science Cited 47 time in Scopus
Authors
Kim, Seung Ho; Lee, Jeong Min; Park, Hee Sun; Eun, Hyo Won; Choi, Byung Ihn; Han, Joon Koo
Issue Date
2009-05
Publisher
JOHN WILEY & SONS INC
Citation
JOURNAL OF MAGNETIC RESONANCE IMAGING; Vol.29 5; 1093-1101
Keywords
rectummagnetic resonance imagingneoplasmschemoradiation
Abstract
Purpose: To evaluate the diagnostic accuracy of MRI for predicting the circumferential resection margin (CRM), mesorectal fascia (MRF) invasion, and the tumor response to neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer. Materials and Methods: Sixty-five consecutive patients with locally advanced rectal cancer (>= T3 or lymph node-positive) who underwent neoadjuvant CRT and subsequent surgery were enrolled in this retrospective study. Two blinded radiologists independently reviewed both the pre- and post-CRT rectal MR images and measured the post-CRT CRM; they recorded their confidence level with respect to the MRF invasion and tumor response using a 5-point scale. The diagnostic accuracy of each reviewer was calculated using receiver operating characteristic curve (ROC) analysis. Results:The measured CRM was not significantly different from the reference standard (mean difference, -1.4 mm; 95% limits of agreement, -8.3-5.4 mm; interclass correlation coefficient. 0.82). The diagnostic accuracy (A(z)) for deter-mining MRF invasion was 0.890 for reviewer 1 (95% confidence interval [CI], 0.788-0.954) and 0.829 for reviewer 2 (95% CI, 0.715-0.911). The A(z) for predicting complete or near-complete regression was 0.791 for reviewer 1 (95% CI, 0.672-0.882) and 0.735 for reviewer 2 (95% CI, 0.611-0.837). Conclusion: MRI provides accurate information regarding the CRM of locally advanced rectal cancer after neoadjuvant CRT: it also shows relatively high accuracy for predicting MRF invasion and moderate accuracy for assessing tumor response.
ISSN
1053-1807
Language
English
URI
https://hdl.handle.net/10371/78089
DOI
https://doi.org/10.1002/jmri.21742
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College of Medicine/School of Medicine (의과대학/대학원)Radiology (영상의학전공)Journal Papers (저널논문_영상의학전공)
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