Morphological and functional features prognostic factor of magnetic resonance imaging in locally advanced rectal cancer

Research output: Contribution to journalArticle

Abstract

Background: Although imaging can be suggestive of the diagnosis of rectal cancer, the primary imaging role is to assist in treatment triage of histologically diagnosed tumors. The possibility of a multimodal approach in the response to the treatment opens the way for the selection of criteria more personalized to the patient. Purpose: To assess the prognostic factor of morphological and functional magnetic resonance imaging (MRI) in rectal cancer. Material and Methods: Seventy-seven patients were enrolled and underwent MRI before treatment and 59 patients underwent MRI after treatment. Radiologists evaluated the presence of lesions using a 4-point confidence scale; they recorded anatomical side, extent, and distance from the anorectal junction and distance from the circumferential margin. Tumor location was classified according to the involvement of proximal rectal channel and/or distal rectal channel. Radiologists scored signal intensity on T2-weighted (T2W) images, diffusion-weighted images (DWI), and MRI dynamic enhancement pattern. Tumor regression grade (TRG) and pathological T (pT) were the gold standard. Results: Lesion vascularization score before treatment showed a predictive value of complete pathological response (sensitivity 88%, specificity 50%) based on pT, while using TRG lymph node number before treatment (sensitivity 83%, specificity 57%) showed a predictive value for response treatment. T2W signal (sensitivity 78%, specificity 30%) and DWI signal after treatment (sensitivity 78%, specificity 61%) showed a good predictive value for local rectal recurrences. Conclusions: Lesion vascularization and lymph node number had a predictive value for neoadjuvant treatment complete response in rectal cancer. T2W signal intensity and DWI signal showed a good predictive value for local rectal recurrences.

Original languageEnglish
Pages (from-to)815-825
Number of pages11
JournalActa Radiologica
Volume60
Issue number7
DOIs
Publication statusPublished - Jul 1 2019

Fingerprint

Rectal Neoplasms
Magnetic Resonance Imaging
Sensitivity and Specificity
Therapeutics
Neoplasms
Lymph Nodes
Recurrence
Neoadjuvant Therapy
Triage
Patient Selection

Keywords

  • magnetic resonance imaging
  • prognostic features
  • Rectal cancer

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{51b2e239143147d8b23f325f2d07b416,
title = "Morphological and functional features prognostic factor of magnetic resonance imaging in locally advanced rectal cancer",
abstract = "Background: Although imaging can be suggestive of the diagnosis of rectal cancer, the primary imaging role is to assist in treatment triage of histologically diagnosed tumors. The possibility of a multimodal approach in the response to the treatment opens the way for the selection of criteria more personalized to the patient. Purpose: To assess the prognostic factor of morphological and functional magnetic resonance imaging (MRI) in rectal cancer. Material and Methods: Seventy-seven patients were enrolled and underwent MRI before treatment and 59 patients underwent MRI after treatment. Radiologists evaluated the presence of lesions using a 4-point confidence scale; they recorded anatomical side, extent, and distance from the anorectal junction and distance from the circumferential margin. Tumor location was classified according to the involvement of proximal rectal channel and/or distal rectal channel. Radiologists scored signal intensity on T2-weighted (T2W) images, diffusion-weighted images (DWI), and MRI dynamic enhancement pattern. Tumor regression grade (TRG) and pathological T (pT) were the gold standard. Results: Lesion vascularization score before treatment showed a predictive value of complete pathological response (sensitivity 88{\%}, specificity 50{\%}) based on pT, while using TRG lymph node number before treatment (sensitivity 83{\%}, specificity 57{\%}) showed a predictive value for response treatment. T2W signal (sensitivity 78{\%}, specificity 30{\%}) and DWI signal after treatment (sensitivity 78{\%}, specificity 61{\%}) showed a good predictive value for local rectal recurrences. Conclusions: Lesion vascularization and lymph node number had a predictive value for neoadjuvant treatment complete response in rectal cancer. T2W signal intensity and DWI signal showed a good predictive value for local rectal recurrences.",
keywords = "magnetic resonance imaging, prognostic features, Rectal cancer",
author = "Roberta Fusco and Vincenza Granata and Daniela Rega and Carolina Russo and Ugo Pace and Biagio Pecori and Fabiana Tatangelo and Gerardo Botti and Francesco Izzo and Marco Cascella and Antonio Avallone and Paolo Delrio and Antonella Petrillo",
year = "2019",
month = "7",
day = "1",
doi = "10.1177/0284185118803783",
language = "English",
volume = "60",
pages = "815--825",
journal = "Acta Radiologica",
issn = "0284-1851",
publisher = "SAGE Publications Ltd",
number = "7",

}

TY - JOUR

T1 - Morphological and functional features prognostic factor of magnetic resonance imaging in locally advanced rectal cancer

AU - Fusco, Roberta

AU - Granata, Vincenza

AU - Rega, Daniela

AU - Russo, Carolina

AU - Pace, Ugo

AU - Pecori, Biagio

AU - Tatangelo, Fabiana

AU - Botti, Gerardo

AU - Izzo, Francesco

AU - Cascella, Marco

AU - Avallone, Antonio

AU - Delrio, Paolo

AU - Petrillo, Antonella

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background: Although imaging can be suggestive of the diagnosis of rectal cancer, the primary imaging role is to assist in treatment triage of histologically diagnosed tumors. The possibility of a multimodal approach in the response to the treatment opens the way for the selection of criteria more personalized to the patient. Purpose: To assess the prognostic factor of morphological and functional magnetic resonance imaging (MRI) in rectal cancer. Material and Methods: Seventy-seven patients were enrolled and underwent MRI before treatment and 59 patients underwent MRI after treatment. Radiologists evaluated the presence of lesions using a 4-point confidence scale; they recorded anatomical side, extent, and distance from the anorectal junction and distance from the circumferential margin. Tumor location was classified according to the involvement of proximal rectal channel and/or distal rectal channel. Radiologists scored signal intensity on T2-weighted (T2W) images, diffusion-weighted images (DWI), and MRI dynamic enhancement pattern. Tumor regression grade (TRG) and pathological T (pT) were the gold standard. Results: Lesion vascularization score before treatment showed a predictive value of complete pathological response (sensitivity 88%, specificity 50%) based on pT, while using TRG lymph node number before treatment (sensitivity 83%, specificity 57%) showed a predictive value for response treatment. T2W signal (sensitivity 78%, specificity 30%) and DWI signal after treatment (sensitivity 78%, specificity 61%) showed a good predictive value for local rectal recurrences. Conclusions: Lesion vascularization and lymph node number had a predictive value for neoadjuvant treatment complete response in rectal cancer. T2W signal intensity and DWI signal showed a good predictive value for local rectal recurrences.

AB - Background: Although imaging can be suggestive of the diagnosis of rectal cancer, the primary imaging role is to assist in treatment triage of histologically diagnosed tumors. The possibility of a multimodal approach in the response to the treatment opens the way for the selection of criteria more personalized to the patient. Purpose: To assess the prognostic factor of morphological and functional magnetic resonance imaging (MRI) in rectal cancer. Material and Methods: Seventy-seven patients were enrolled and underwent MRI before treatment and 59 patients underwent MRI after treatment. Radiologists evaluated the presence of lesions using a 4-point confidence scale; they recorded anatomical side, extent, and distance from the anorectal junction and distance from the circumferential margin. Tumor location was classified according to the involvement of proximal rectal channel and/or distal rectal channel. Radiologists scored signal intensity on T2-weighted (T2W) images, diffusion-weighted images (DWI), and MRI dynamic enhancement pattern. Tumor regression grade (TRG) and pathological T (pT) were the gold standard. Results: Lesion vascularization score before treatment showed a predictive value of complete pathological response (sensitivity 88%, specificity 50%) based on pT, while using TRG lymph node number before treatment (sensitivity 83%, specificity 57%) showed a predictive value for response treatment. T2W signal (sensitivity 78%, specificity 30%) and DWI signal after treatment (sensitivity 78%, specificity 61%) showed a good predictive value for local rectal recurrences. Conclusions: Lesion vascularization and lymph node number had a predictive value for neoadjuvant treatment complete response in rectal cancer. T2W signal intensity and DWI signal showed a good predictive value for local rectal recurrences.

KW - magnetic resonance imaging

KW - prognostic features

KW - Rectal cancer

UR - http://www.scopus.com/inward/record.url?scp=85060535397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060535397&partnerID=8YFLogxK

U2 - 10.1177/0284185118803783

DO - 10.1177/0284185118803783

M3 - Article

AN - SCOPUS:85060535397

VL - 60

SP - 815

EP - 825

JO - Acta Radiologica

JF - Acta Radiologica

SN - 0284-1851

IS - 7

ER -