Liheng Liu1,2, Linke Yang3, Erhu Jin4, Zhenchang Wang1, Zhenghan Yang1. 1. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong'an Road 95, Beijing, 100050, People's Republic of China. 2. Department of Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, People's Republic of China. 3. Department of Pathology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, People's Republic of China. 4. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong'an Road 95, Beijing, 100050, People's Republic of China. drerhujin@163.com.
Abstract
PURPOSE: To evaluate the performance of gadolinium contrast-enhanced T1-weighted magnetic resonance imaging (CET1WI) in addition to high-resolution T2-weighted imaging (HRT2WI) for preoperative detection of extramural venous invasion (EMVI) in rectal cancer. METHODS: Fifty-nine patients with rectal cancer who underwent preoperative MRI were included in this study. The likelihood of EMVI was retrospectively scored by two readers on CET1WI, HRT2WI, and HRT2WI + CET1WI, using a subjective five-point scale ranging from 0 to 4. The pathological status of EMVI was used as a standard reference. Diagnostic parameters, including area under the receiver operating curve (AUC), sensitivity, and specificity, were calculated, and the diagnostic performances of HRT2WI and HRT2WI + CET1WI were compared. Interobserver variance was also evaluated. RESULTS: Eighteen (30.5%) patients showed pathological EMVI. During EMVI detection, reader A obtained an AUC of 0.768, sensitivity of 72.5%, and specificity of 73.2% from HRT2WI alone; after combination with CET1WI, these values improved to 0.864, 83.3%, and 75.6%, respectively. Differences in AUC between these techniques were not significant (p = 0.056). Reader B obtained an AUC of 0.833, sensitivity of 77.8%, and specificity of 73.2% from HRT2WI alone; after combination with CET1W1, these figures were adjusted to 0.720, 50%, and 78%; differences in AUC between techniques were significant (p = 0.027). Interobserver agreement during EMVI scoring was good for HRT2WI (κ = 0.603) and moderate for HRT2WI + CET1WI (κ = 0.413). CONCLUSIONS: Although interobserver agreement decreased, combination of CET1WI with HRT2WI could improve EMVI detection.
PURPOSE: To evaluate the performance of gadolinium contrast-enhanced T1-weighted magnetic resonance imaging (CET1WI) in addition to high-resolution T2-weighted imaging (HRT2WI) for preoperative detection of extramural venous invasion (EMVI) in rectal cancer. METHODS: Fifty-nine patients with rectal cancer who underwent preoperative MRI were included in this study. The likelihood of EMVI was retrospectively scored by two readers on CET1WI, HRT2WI, and HRT2WI + CET1WI, using a subjective five-point scale ranging from 0 to 4. The pathological status of EMVI was used as a standard reference. Diagnostic parameters, including area under the receiver operating curve (AUC), sensitivity, and specificity, were calculated, and the diagnostic performances of HRT2WI and HRT2WI + CET1WI were compared. Interobserver variance was also evaluated. RESULTS: Eighteen (30.5%) patients showed pathological EMVI. During EMVI detection, reader A obtained an AUC of 0.768, sensitivity of 72.5%, and specificity of 73.2% from HRT2WI alone; after combination with CET1WI, these values improved to 0.864, 83.3%, and 75.6%, respectively. Differences in AUC between these techniques were not significant (p = 0.056). Reader B obtained an AUC of 0.833, sensitivity of 77.8%, and specificity of 73.2% from HRT2WI alone; after combination with CET1W1, these figures were adjusted to 0.720, 50%, and 78%; differences in AUC between techniques were significant (p = 0.027). Interobserver agreement during EMVI scoring was good for HRT2WI (κ = 0.603) and moderate for HRT2WI + CET1WI (κ = 0.413). CONCLUSIONS: Although interobserver agreement decreased, combination of CET1WI with HRT2WI could improve EMVI detection.
Entities:
Keywords:
Contrast agent; Diagnosis; Magnetic resonance imaging; Neoplasm invasiveness; Rectal cancer