BACKGROUND: The restaging accuracy of MR imaging in advanced primary rectal carcinoma after preoperative radiochemotherapy and regional hyperthermia was evaluated and compared with the histopathologically verified degree of tumor remission after a course of radio-chemo-thermotherapy. PATIENTS AND METHODS: 35 patients with primary rectal carcinoma (uT3/uT4) underwent MRI using a surface coil 4-6 weeks after radiochemotherapy (n = 35), regional hyperthermia (n = 23), and before curative surgery. We defined as gold standard for the remission status the comparison of pretherapeutic endosonography with the histopathology of the resected specimen. RESULTS: T category was correctly restaged after preoperative treatment in only 19 (54%) of 35 patients. Nine of 20 responders were overstaged and seven of 15 non-responders were understaged. Concurrently, the N category was correctly restaged in 19 (54%) of 35 patients (twelve responders and seven non-responders). Overstaging occurred in four responders and two non-responders, understaging occurred in four responders and six non-responders. CONCLUSIONS: MRI proved independent of the response status as not suitable to restage locally advanced rectal carcinoma after preoperative radiochemotherapy despite optimized imaging technique and spatial resolution. Basically, imaging the morphology of a tumor cannot clearly differentiate between vital and devitalized tissue after a treatment. Functional imaging such as PET (positron emission tomography) appears more feasible for restaging after radio-chemo-thermotherapy.
BACKGROUND: The restaging accuracy of MR imaging in advanced primary rectal carcinoma after preoperative radiochemotherapy and regional hyperthermia was evaluated and compared with the histopathologically verified degree of tumor remission after a course of radio-chemo-thermotherapy. PATIENTS AND METHODS: 35 patients with primary rectal carcinoma (uT3/uT4) underwent MRI using a surface coil 4-6 weeks after radiochemotherapy (n = 35), regional hyperthermia (n = 23), and before curative surgery. We defined as gold standard for the remission status the comparison of pretherapeutic endosonography with the histopathology of the resected specimen. RESULTS: T category was correctly restaged after preoperative treatment in only 19 (54%) of 35 patients. Nine of 20 responders were overstaged and seven of 15 non-responders were understaged. Concurrently, the N category was correctly restaged in 19 (54%) of 35 patients (twelve responders and seven non-responders). Overstaging occurred in four responders and two non-responders, understaging occurred in four responders and six non-responders. CONCLUSIONS: MRI proved independent of the response status as not suitable to restage locally advanced rectal carcinoma after preoperative radiochemotherapy despite optimized imaging technique and spatial resolution. Basically, imaging the morphology of a tumor cannot clearly differentiate between vital and devitalized tissue after a treatment. Functional imaging such as PET (positron emission tomography) appears more feasible for restaging after radio-chemo-thermotherapy.
Authors: Gregor Bruggmoser; Stefan Bauchowitz; Richard Canters; Hans Crezee; Michael Ehmann; Johanna Gellermann; Ulf Lamprecht; Nicoletta Lomax; Marc Benjamin Messmer; Oliver Ott; Sultan Abdel-Rahman; Rolf Sauer; Manfred Schmidt; Andreas Thomsen; Rüdiger Wessalowski; Gerard van Rhoon Journal: Strahlenther Onkol Date: 2011-09-19 Impact factor: 3.621
Authors: G Bruggmoser; S Bauchowitz; R Canters; H Crezee; M Ehmann; J Gellermann; U Lamprecht; N Lomax; M B Messmer; O Ott; S Abdel-Rahman; M Schmidt; R Sauer; A Thomsen; R Wessalowski; G van Rhoon Journal: Strahlenther Onkol Date: 2012-09 Impact factor: 3.621
Authors: T Denecke; B Rau; K-T Hoffmann; B Hildebrandt; J Ruf; M Gutberlet; M Hünerbein; R Felix; P Wust; H Amthauer Journal: Eur Radiol Date: 2005-04-02 Impact factor: 5.315
Authors: Michael R Torkzad; Johan Lindholm; Anna Martling; Björn Cedermark; Bengt Glimelius; Lennart Blomqvist Journal: Eur Radiol Date: 2007-01-31 Impact factor: 5.315