Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/69977
Title: Primary and post-chemoradiotherapy staging using MRI in rectal cancer: the role of diffusion imaging in the assessment of perirectal infiltration
Authors: Fornell-Perez, Roberto
Perez-Alonso, Esteban 
Porcel-de-Peralta, Gabriela
Duran-Castellon, Alfonso
Vivas-Escalona, Valentina
Aranda-Sanchez, Joel
Gonzalez-Dominguez, Maria Carmen
Rubio-Garcia, Jano
Alemán-Flores, Patricia
Lozano-Rodriguez, Alvaro
Orihuela-de-la-Cal, Maria Elena
Loro-Ferrer, Juan Francisco 
UNESCO Clasification: 32 Ciencias médicas
Keywords: Diffusion-Weighted Imaging
Magnetic Resonance Imaging
Neoadjuvant Chemoradiotherapy
Rectal Neoplasms
Issue Date: 2019
Journal: Abdominal Radiology 
Abstract: Purpose: To analyze changes in MRI diagnostic accuracy in main rectal tumor (T) evaluation resulting from the use of diffusion-weighted imaging (DWI), according to the degree of experience of the radiologist. Methods: This is a cross-sectional study of a database including one hundred 1.5 T MRI records (2011–2016) from patients with biopsy-proven rectal cancer, including primary staging and post-chemoradiotherapy follow-up. All cases were individually blindedly reviewed by ten radiologists: three experienced in rectal cancer, three specialized in other areas, and four residents. Each case was assessed twice to detect perirectal infiltration: first, evaluating just high-resolution T2-weighted sequences (HRT2w); second, evaluation of DWI plus HRT2w sequences. Results were pooled by experience, calculating accuracy (area under ROC curve), sensitivity and specificity, predictive values, likelihood ratios, and overstaging/understaging. Histology of surgical specimens provided the reference standard. Results: DWI significantly improved specificity by experienced radiologists in primary staging (63.2% to 75.9%) and, to a lesser extent, positive likelihood ratio (2.06 to 2.87); minimal changes were observed post-chemoradiotherapy, with a slight decrease of accuracy (0.657 to 0.626). Inexperienced radiologists showed a similar pattern, but with slight enhancement post-chemoradiotherapy (accuracy 0.604 to 0.621). Residents experienced small changes, with increased sensitivity/decreased specificity in both primary (69% to 72%/67.2% to 64.7%) and post-chemoradiotherapy (68.1% to 73.6%/47.3% to 44.6%) staging. Conclusions: Adding DWI to HRT2w significantly improved specificity for the detection of perirectal infiltration at primary staging by experienced radiologists and also by inexperienced ones, although to a lesser extent. In the post-neoadjuvant treatment subgroup, only minimal changes were observed.
URI: http://hdl.handle.net/10553/69977
ISSN: 2366-004X
DOI: 10.1007/s00261-019-02139-4
Source: Abdominal Radiology [ISSN 2366-004X], v. 44 (11), p. 3674-3682
Appears in Collections:Artículos
Show full item record

SCOPUSTM   
Citations

7
checked on Nov 27, 2022

WEB OF SCIENCETM
Citations

7
checked on Oct 2, 2022

Page view(s)

54
checked on Oct 8, 2022

Google ScholarTM

Check

Altmetric


Share



Export metadata



Items in accedaCRIS are protected by copyright, with all rights reserved, unless otherwise indicated.