Value of ADC measurements for nodal staging after chemoradiation in locally advanced rectal cancer-a per lesion validation study.
Eur Radiol
; 21(2): 265-73, 2011 Feb.
Article
em En
| MEDLINE
| ID: mdl-20730540
ABSTRACT
OBJECTIVES:
To evaluate the performance of diffusion-weighted MRI (DWI) in addition to T2-weighted (T2W) MRI for nodal restaging after chemoradiation in rectal cancer.METHODS:
Thirty patients underwent chemoradiation followed by MRI (1.5 T) and surgery. Imaging consisted of T2W-MRI and DWI (b0, 500, 1000). On T2W-MRI, nodes were scored as benign/malignant by two independent readers (R1, R2). Mean apparent diffusion coefficient (ADC) was measured for each node. Diagnostic performance was compared for T2W-MRI, ADC and T2W+ADC, using a per lesion histological validation.RESULTS:
ADC was higher for the malignant nodes (1.43 ± 0.38 vs 1.19 ± 0.27 *10⻳ mm²/s, p < 0.001). Area under the ROC curve/sensitivity/specificity were 0.88/65%/93% (R1) and 0.95/71%/91% (R2) using T2W-MRI; 0.66/53%/82% using ADC (mean of two readers); and 0.91/56%/98% (R1) and 0.96/56%/99% (R2) using T2W+ADC. There was no significant difference between T2W-MRI and T2W+ADC. Interobserver reproducibility was good for T2W-MRI (κ0.73) and ADC (intraclass correlation coefficient 0.77).CONCLUSIONS:
After chemoradiation, ADC measurements may have potential for nodal characterisation, but DWI on its own is not reliable. Addition of DWI to T2W-MRI does not improve accuracy and T2W-MRI is already sufficiently accurate.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Imageamento por Ressonância Magnética
/
Adenocarcinoma
/
Recidiva Local de Neoplasia
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article