OBJECTIVES: To evaluate the performance of diffusion-weighted MRI (DWI) for the detection of lymph nodes and for differentiating between benign and metastatic nodes during primary rectal cancer staging. METHODS: Twenty-one patients underwent 1.5-T MRI followed by surgery (± preoperative 5 × 5 Gy). Imaging consisted of T2-weighted MRI, DWI (b0, 500, 1000), and 3DT1-weighted MRI with 1-mm isotropic voxels. The latter was used for accurate detection and per lesion histological validation of nodes. Two independent readers analysed the signal intensity on DWI and measured the mean apparent diffusion coefficient (ADC) for each node (ADCnode) and the ADC of each node relative to the mean tumour ADC (ADCrel). RESULTS: DWI detected 6 % more nodes than T2W-MRI. The signal on DWI was not accurate for the differentiation of metastatic nodes (AUC 0.45-0.50). Interobserver reproducibility for the nodal ADC measurements was excellent (ICC 0.93). Mean ADCnode was higher for benign than for malignant nodes (1.15 ± 0.24 vs. 1.04 ± 0.22 *10(-3) mm(2)/s), though not statistically significant (P = 0.10). Area under the ROC curve/sensitivity/specificity for the assessment of metastatic nodes were 0.64/67 %/60 % for ADCnode and 0.67/75 %/61 % for ADCrel. CONCLUSIONS: DWI can facilitate lymph node detection, but alone it is not reliable for differentiating between benign and malignant lymph nodes.
OBJECTIVES: To evaluate the performance of diffusion-weighted MRI (DWI) for the detection of lymph nodes and for differentiating between benign and metastatic nodes during primary rectal cancer staging. METHODS: Twenty-one patients underwent 1.5-T MRI followed by surgery (± preoperative 5 × 5 Gy). Imaging consisted of T2-weighted MRI, DWI (b0, 500, 1000), and 3DT1-weighted MRI with 1-mm isotropic voxels. The latter was used for accurate detection and per lesion histological validation of nodes. Two independent readers analysed the signal intensity on DWI and measured the mean apparent diffusion coefficient (ADC) for each node (ADCnode) and the ADC of each node relative to the mean tumour ADC (ADCrel). RESULTS: DWI detected 6 % more nodes than T2W-MRI. The signal on DWI was not accurate for the differentiation of metastatic nodes (AUC 0.45-0.50). Interobserver reproducibility for the nodal ADC measurements was excellent (ICC 0.93). Mean ADCnode was higher for benign than for malignant nodes (1.15 ± 0.24 vs. 1.04 ± 0.22 *10(-3) mm(2)/s), though not statistically significant (P = 0.10). Area under the ROC curve/sensitivity/specificity for the assessment of metastatic nodes were 0.64/67 %/60 % for ADCnode and 0.67/75 %/61 % for ADCrel. CONCLUSIONS: DWI can facilitate lymph node detection, but alone it is not reliable for differentiating between benign and malignant lymph nodes.
Authors: Shandra Bipat; Afina S Glas; Frederik J M Slors; Aeilko H Zwinderman; Patrick M M Bossuyt; Jaap Stoker Journal: Radiology Date: 2004-07-23 Impact factor: 11.105
Authors: R G Beets-Tan; G L Beets; R F Vliegen; A G Kessels; H Van Boven; A De Bruine; M F von Meyenfeldt; C G Baeten; J M van Engelshoven Journal: Lancet Date: 2001-02-17 Impact factor: 79.321
Authors: C A Marijnen; I D Nagtegaal; E Klein Kranenbarg; J Hermans; C J van de Velde; J W Leer; J H van Krieken Journal: J Clin Oncol Date: 2001-04-01 Impact factor: 44.544
Authors: Max J Lahaye; Geerard L Beets; Sanne M E Engelen; Alfons G H Kessels; Adriaan P de Bruïne; Herry W S Kwee; Jos M A van Engelshoven; Cornelis J H van de Velde; Regina G H Beets-Tan Journal: Radiology Date: 2009-04-29 Impact factor: 11.105
Authors: Max J Lahaye; Sanne M E Engelen; Alfons G H Kessels; Adriaan P de Bruïne; Maarten F von Meyenfeldt; Jos M A van Engelshoven; Cornelis J H van de Velde; Geerard L Beets; Regina G H Beets-Tan Journal: Radiology Date: 2008-01-14 Impact factor: 11.105
Authors: Vincent Vandecaveye; Frederik De Keyzer; Vincent Vander Poorten; Piet Dirix; Eric Verbeken; Sandra Nuyts; Robert Hermans Journal: Radiology Date: 2009-02-27 Impact factor: 11.105
Authors: Riccardo De Robertis; Paolo Tinazzi Martini; Emanuele Demozzi; Flavia Dal Corso; Claudio Bassi; Paolo Pederzoli; Mirko D'Onofrio Journal: World J Radiol Date: 2015-10-28