Radovan Vojtíšek1, Eva Korčáková2, Jan Mařan1, Ondřej Šorejs1, Jindřich Fínek1. 1. Department of Oncology and Radiotherapy, University Hospital in Pilsen, alej Svobody 80, 304 60 Pilsen, Czech Republic. 2. Department of Imaging Methods, University Hospital in Pilsen, alej Svobody 80, 304 60 Pilsen, Czech Republic.
Abstract
AIM: To figure out how to correlate the findings on functional MRI and carried out after neoadjuvant CRT of rectal carcinoma with final histology after surgery. BACKGROUND: Neoadjuvant CRT is the standard treatment of locally advanced rectal carcinoma. Its use leads to the downstaging of the disease and in 15-42% of patients even to the detection of pCR after TME. The use of functional MRI improves the sensitivity and specificity of pCR detection up to 52-64% and 89-98%, respectively. MATERIALS AND METHODS: Between January 2013 and June 2016, 67 patients suffering from histologically proven locally advanced rectal cancer underwent neoadjuvant RT or CRT. We selected for further investigation only patients (33 patients) who underwent pelvic staging and restaging using multiparametric imaging on 3T MRI scanner. We compared the findings on functional MRI after neoadjuvant CRT with final histology after surgery. RESULTS: In 15 patients pathologic staging of primary tumor differed from expected staging assessed according to preoperative MRI. In 5 patients pathologic complete remission was achieved. In none of these 5 patients pCR was predicted using preoperative MRI. Sensitivity and specificity of MRI in predicting pCR were 0% and 96%. Accuracy of MRI in predicting pT and pN was 79% and 74%. CONCLUSIONS: We have verified that the use of neoadjuvant CRT in the treatment of locally advanced rectal carcinoma leads to a possible achievement of pCR. But in our group of patients this was not predictable nor was it with the use of multiparametric 3T MRI.
AIM: To figure out how to correlate the findings on functional MRI and carried out after neoadjuvant CRT of rectal carcinoma with final histology after surgery. BACKGROUND: Neoadjuvant CRT is the standard treatment of locally advanced rectal carcinoma. Its use leads to the downstaging of the disease and in 15-42% of patients even to the detection of pCR after TME. The use of functional MRI improves the sensitivity and specificity of pCR detection up to 52-64% and 89-98%, respectively. MATERIALS AND METHODS: Between January 2013 and June 2016, 67 patients suffering from histologically proven locally advanced rectal cancer underwent neoadjuvant RT or CRT. We selected for further investigation only patients (33 patients) who underwent pelvic staging and restaging using multiparametric imaging on 3T MRI scanner. We compared the findings on functional MRI after neoadjuvant CRT with final histology after surgery. RESULTS: In 15 patients pathologic staging of primary tumor differed from expected staging assessed according to preoperative MRI. In 5 patients pathologic complete remission was achieved. In none of these 5 patients pCR was predicted using preoperative MRI. Sensitivity and specificity of MRI in predicting pCR were 0% and 96%. Accuracy of MRI in predicting pT and pN was 79% and 74%. CONCLUSIONS: We have verified that the use of neoadjuvant CRT in the treatment of locally advanced rectal carcinoma leads to a possible achievement of pCR. But in our group of patients this was not predictable nor was it with the use of multiparametric 3T MRI.
Authors: M J Gollub; D H Gultekin; O Akin; R K Do; J L Fuqua; M Gonen; D Kuk; M Weiser; L Saltz; D Schrag; K Goodman; P Paty; J Guillem; G M Nash; L Temple; J Shia; L H Schwartz Journal: Eur Radiol Date: 2011-11-20 Impact factor: 5.315
Authors: Sthela M Murad-Regadas; Francisco Sergio P Regadas; Lusmar V Rodrigues; Rosilma G L Barreto; Francisco Coracy C Monteiro; Beethoven B Landim; Erico C Holanda Journal: Surg Endosc Date: 2008-09-24 Impact factor: 4.584
Authors: Matthew F Kalady; Luiz Felipe de Campos-Lobato; Luca Stocchi; Daniel P Geisler; David Dietz; Ian C Lavery; Victor W Fazio Journal: Ann Surg Date: 2009-10 Impact factor: 12.969