PMID- 35852424
OWN - NLM
STAT- MEDLINE
DCOM- 20221026
LR  - 20221031
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 305
IP  - 2
DP  - 2022 Nov
TI  - Contrast-enhanced MRI for T Restaging of Locally Advanced Rectal Cancer Following 
      Neoadjuvant Chemotherapy and Radiation Therapy.
PG  - 364-372
LID - 10.1148/radiol.212905 [doi]
AB  - Background Accurate restaging of rectal cancer is crucial in the selection of 
      candidates for local excision after neoadjuvant chemotherapy and radiation 
      therapy (NCRT). The conventional approach of combined T2-weighted imaging and 
      diffusion-weighted imaging (DWI) at MRI has been found to have limitations in 
      restaging. Purpose To determine the diagnostic performance of contrast-enhanced 
      MRI in distinguishing between pathologic stage ypT0-1 and ypT2-4 rectal cancer 
      after NCRT compared with T2-weighted imaging and DWI by using surgical pathologic 
      specimens as the reference standard. Materials and Methods This retrospective 
      study evaluated MRI scans in all consecutive patients with locally advanced 
      rectal cancer who underwent total mesorectal excision after NCRT in Peking 
      University Cancer Hospital (Beijing, China) from January 2014 to October 2018. 
      All MRI features obtained before and after NCRT were evaluated by two experienced 
      radiologists, independently and blinded to personal, clinical, and 
      histopathologic information. The post-NCRT yT stage was assigned based on high b 
      value (b = 1000 sec/mm(2)) DWI with T2-weighted imaging (protocol 1) in the first 
      round and on contrast-enhanced MRI scans (protocol 2) in a second round. The 
      diagnostic accuracies for the differentiation of pathologic stage ypT0-1 from 
      ypT2-4 tumors with the two protocols were compared. Multivariable regression 
      analysis was used to explore the independent predictors of pathologic stage 
      ypT0-1 tumors. Results A total of 328 patients (mean age, 57 years +/- 10 [SD]; 227 
      men; 69%) were enrolled. The area under the receiver operating characteristic 
      curve of the contrast-enhanced MRI protocol in predicting pathologic stage ypT0-1 
      tumors was 0.81 (95% CI: 0.77, 0.85), which was better than that of the 
      T2-weighted DWI protocol (0.66; 95% CI: 0.60, 0.71; P < .001). Multivariable 
      logistic regression analysis showed that yT stage after NCRT on contrast-enhanced 
      MRI scans was the only independent predictor of pathologic stage ypT0-1 tumors (P 
      < .001). Conclusion Contrast-enhanced MRI provides accurate differentiation of 
      ypT0-1 from ypT2-4 tumors after neoadjuvant chemotherapy and radiation therapy. (c) 
      RSNA, 2022 Online supplemental material is available for this article. See also 
      the editorial by Zins and Santiago in this issue.
FAU - Lu, Qiao-Yuan
AU  - Lu QY
AD  - From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Radiology, Peking University Cancer Hospital 
      and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China.
FAU - Guan, Zhen
AU  - Guan Z
AUID- ORCID: 0000-0002-6270-0614
AD  - From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Radiology, Peking University Cancer Hospital 
      and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China.
FAU - Zhang, Xiao-Yan
AU  - Zhang XY
AD  - From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Radiology, Peking University Cancer Hospital 
      and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China.
FAU - Li, Xiao-Ting
AU  - Li XT
AD  - From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Radiology, Peking University Cancer Hospital 
      and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China.
FAU - Sun, Rui-Jia
AU  - Sun RJ
AD  - From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Radiology, Peking University Cancer Hospital 
      and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China.
FAU - Li, Qing-Yang
AU  - Li QY
AD  - From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Radiology, Peking University Cancer Hospital 
      and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China.
FAU - Sun, Ying-Shi
AU  - Sun YS
AUID- ORCID: 0000-0001-9424-1910
AD  - From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Radiology, Peking University Cancer Hospital 
      and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220719
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
SB  - IM
CIN - Radiology. 2022 Jul 19;:221397. PMID: 35852433
MH  - Male
MH  - Humans
MH  - Middle Aged
MH  - Neoadjuvant Therapy/methods
MH  - Chemoradiotherapy/methods
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Rectal Neoplasms/diagnostic imaging/therapy
MH  - Magnetic Resonance Imaging/methods
MH  - *Neoplasms, Second Primary
EDAT- 2022/07/20 06:00
MHDA- 2022/10/27 06:00
CRDT- 2022/07/19 09:52
PHST- 2022/07/20 06:00 [pubmed]
PHST- 2022/10/27 06:00 [medline]
PHST- 2022/07/19 09:52 [entrez]
AID - 10.1148/radiol.212905 [doi]
PST - ppublish
SO  - Radiology. 2022 Nov;305(2):364-372. doi: 10.1148/radiol.212905. Epub 2022 Jul 19.