PURPOSE: To prospectively assess the added value of gadolinium-enhanced and diffusion-weighted (DWI) MRI for the diagnosis of pelvic recurrence from colorectal cancer (CRC). MATERIALS AND METHODS: Fifty-two patients with suspected pelvic recurrence from CRC underwent pelvic MRI with T2-weighted ("T2"), gadolinium-enhanced fat-suppressed T1-weighted ("gadolinium") and DWI MR sequences. Three readers (senior radiologist: R1, two residents: R2, R3) scored the likelihood of recurrence on "T2," "T2 + DWI," and "T2 + Gadolinium." RESULTS:Twenty-seven patients had 42 sites of pelvic recurrence. On "T2," R1 achieved AUC of .95, sensitivity 88.4%, specificity 95.2%. For R2, these figures were .89, 81.4%, 90.5%, for R3 .90, 83.7%, 76%. Both Gadolinium injection and DWI significantly improved AUCs for residents but not for the senior radiologist: up to .988 (R2, P = 0.006) and to .98 (R3, P = 0.01) with DWI and to .96 (R2, P = 0.04), .98 (R3, P = 0.01) after gadolinium. All readers achieved slightly better AUCs with "T2 + DWI" than with "T2+Gadolinium" but not significantly (P = 0.68, P = 0.11, P = 0.3; respectively). CONCLUSION: For diagnosis of pelvic recurrence from CRC, both DWI and gadolinium-enhanced MRI significantly increase diagnostic performances compared with "T2" MRI for residents. DWI may be helpful in patients with contra-indications to intravenous administration of gadolinium.
RCT Entities:
PURPOSE: To prospectively assess the added value of gadolinium-enhanced and diffusion-weighted (DWI) MRI for the diagnosis of pelvic recurrence from colorectal cancer (CRC). MATERIALS AND METHODS: Fifty-two patients with suspected pelvic recurrence from CRC underwent pelvic MRI with T2-weighted ("T2"), gadolinium-enhanced fat-suppressed T1-weighted ("gadolinium") and DWI MR sequences. Three readers (senior radiologist: R1, two residents: R2, R3) scored the likelihood of recurrence on "T2," "T2 + DWI," and "T2 + Gadolinium." RESULTS: Twenty-seven patients had 42 sites of pelvic recurrence. On "T2," R1 achieved AUC of .95, sensitivity 88.4%, specificity 95.2%. For R2, these figures were .89, 81.4%, 90.5%, for R3 .90, 83.7%, 76%. Both Gadolinium injection and DWI significantly improved AUCs for residents but not for the senior radiologist: up to .988 (R2, P = 0.006) and to .98 (R3, P = 0.01) with DWI and to .96 (R2, P = 0.04), .98 (R3, P = 0.01) after gadolinium. All readers achieved slightly better AUCs with "T2 + DWI" than with "T2+Gadolinium" but not significantly (P = 0.68, P = 0.11, P = 0.3; respectively). CONCLUSION: For diagnosis of pelvic recurrence from CRC, both DWI and gadolinium-enhanced MRI significantly increase diagnostic performances compared with "T2" MRI for residents. DWI may be helpful in patients with contra-indications to intravenous administration of gadolinium.
Authors: Barbara J Amorim; Theodore S Hong; Lawrence S Blaszkowsky; Cristina R Ferrone; David L Berger; Liliana G Bordeianou; Rocco Ricciardi; Jeffrey W Clark; David P Ryan; Jennifer Y Wo; Motaz Qadan; Mark Vangel; Lale Umutlu; David Groshar; Lina G Cañamaques; Debra A Gervais; Umar Mahmood; Bruce R Rosen; Onofrio A Catalano Journal: Eur J Nucl Med Mol Imaging Date: 2019-07-29 Impact factor: 9.236
Authors: Doenja M J Lambregts; Max J Lahaye; Luc A Heijnen; Milou H Martens; Monique Maas; Geerard L Beets; Regina G H Beets-Tan Journal: Eur Radiol Date: 2015-10-30 Impact factor: 5.315