Controversy in the initial nodal staging of rectal cancer (MRI or PET/CT?).
Rev Esp Med Nucl Imagen Mol (Engl Ed)
; 43(3): 500004, 2024.
Article
en En
| MEDLINE
| ID: mdl-38527730
ABSTRACT
OBJECTIVE:
To compare the usefulness of MRI and PET/CT in nodal staging (N) of patients with locally advanced rectal cancer (LARC). MATERIAL ANDMETHODS:
Retrospective study of patients with LARC, who completed their initial staging with PET/CT, between January-20 and March-23. Regional nodes were assessed, and N was determined using both techniques according to TNM criteria. Concordance between MRI and PET/CT was analyzed. The accuracy of both techniques was calculated for those patients who underwent direct surgery. Non-regional pelvic lymph nodes were evaluated by both modalities.RESULTS:
Among the 73 patients, 48 were ultimately diagnosed with a locally advanced stage. Of these, 39 underwent neoadjuvant treatment (chemoradiotherapy) followed by surgery, and 9 direct surgery. In 25, the PET/CT extension study revealed distant disease, leading to systemic treatment. Weak concordance was observed between MRI and PET/CT in determining N (k=0.286; p<0.005). Out of 73 patients, 31(42%) exhibited concordance, and 42(58%) showed discordance. In 83% of the discordant cases, MRI overstaged compared to PET/CT, with 17 cases indicating nodal involvement (N+) by MRI and N0 by PET/CT. Diagnostic accuracy was 78% for both techniques. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 75%, 80%, and 75% for MRI, and 60%, 100%, 100%, and 67%, for PET/CT. PET/CT identified pelvic metastatic adenopathies in 8 patients that were not visible/doubtful by MRI.CONCLUSIONS:
In the initial nodal staging of rectal cancer MRI overstages relative to PET/CT. Both modalities are complementary, PET/CT offers higher specificity and MRI higher sensitivity.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
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Imagen por Resonancia Magnética
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Tomografía Computarizada por Tomografía de Emisión de Positrones
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Metástasis Linfática
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Estadificación de Neoplasias
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Rev Esp Med Nucl Imagen Mol (Engl Ed)
Año:
2024
Tipo del documento:
Article