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The value of high-resolution MRI technique in patients with rectal carcinoma: pre-operative assessment of mesorectal fascia involvement, circumferential resection margin and local staging.

Algebally AM, Mohey N, Szmigielski W, Yousef RR, Kohla S - Pol J Radiol (2015)

Bottom Line: MRI findings were compared with pathological and surgical results.The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively.MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Zagazig University, Zagazig, Egypt.

ABSTRACT

Background: The purpose of the study was to identify the accuracy of high-resolution MRI in the pre-operative assessment of mesorectal fascia involvement, circumfrential resection margin (CRM) and local staging in patients with rectal carcinoma.

Material/methods: The study included 56 patients: 32 male and 24 female. All patients underwent high-resolution MRI and had confirmed histopathological diagnosis of rectal cancer located within 15 cm from the anal verge, followed by surgery. MRI findings were compared with pathological and surgical results.

Results: The overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI-based T-staging were 92.8, 88.8%, 96.5%, 96%, and 90.3%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based assessment of CRM were 94.6%, 84.6%, 97.6%, 91.4, and 94.6%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively.

Conclusions: Preoperative high-resolution rectal MRI is accurate in predicting tumor stage and CRM involvement. MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery.

No MeSH data available.


Related in: MedlinePlus

Male, 53 year-old with histopathologically proven T2 stage rectal carcinoma. (A) High resolution MRI axial T2WI: Concentric rectal mass (white arrow) with reticulo-nodular stranding of the mesorectal fat at the left antero-lateral aspect (black arrow). Enlarged lymph node on the left side of the mesorectal fat (arrow head), (B) sagittal T2WI: Rectal mass (arrow).
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f1-poljradiol-80-115: Male, 53 year-old with histopathologically proven T2 stage rectal carcinoma. (A) High resolution MRI axial T2WI: Concentric rectal mass (white arrow) with reticulo-nodular stranding of the mesorectal fat at the left antero-lateral aspect (black arrow). Enlarged lymph node on the left side of the mesorectal fat (arrow head), (B) sagittal T2WI: Rectal mass (arrow).

Mentions: The T-staging based on MRI findings is summarized in Table 1. Histopathological staging revealed intramural lesions (T1+T2 stage) in 20 patients (35.7%, Figure 1), T3 in 26 patients (46.4%, Figures 2–4) and T4 in 10 patients (17.9%, Figure 5). The histopathological staging is summarized in Table 2.


The value of high-resolution MRI technique in patients with rectal carcinoma: pre-operative assessment of mesorectal fascia involvement, circumferential resection margin and local staging.

Algebally AM, Mohey N, Szmigielski W, Yousef RR, Kohla S - Pol J Radiol (2015)

Male, 53 year-old with histopathologically proven T2 stage rectal carcinoma. (A) High resolution MRI axial T2WI: Concentric rectal mass (white arrow) with reticulo-nodular stranding of the mesorectal fat at the left antero-lateral aspect (black arrow). Enlarged lymph node on the left side of the mesorectal fat (arrow head), (B) sagittal T2WI: Rectal mass (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4356185&req=5

f1-poljradiol-80-115: Male, 53 year-old with histopathologically proven T2 stage rectal carcinoma. (A) High resolution MRI axial T2WI: Concentric rectal mass (white arrow) with reticulo-nodular stranding of the mesorectal fat at the left antero-lateral aspect (black arrow). Enlarged lymph node on the left side of the mesorectal fat (arrow head), (B) sagittal T2WI: Rectal mass (arrow).
Mentions: The T-staging based on MRI findings is summarized in Table 1. Histopathological staging revealed intramural lesions (T1+T2 stage) in 20 patients (35.7%, Figure 1), T3 in 26 patients (46.4%, Figures 2–4) and T4 in 10 patients (17.9%, Figure 5). The histopathological staging is summarized in Table 2.

Bottom Line: MRI findings were compared with pathological and surgical results.The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively.MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Zagazig University, Zagazig, Egypt.

ABSTRACT

Background: The purpose of the study was to identify the accuracy of high-resolution MRI in the pre-operative assessment of mesorectal fascia involvement, circumfrential resection margin (CRM) and local staging in patients with rectal carcinoma.

Material/methods: The study included 56 patients: 32 male and 24 female. All patients underwent high-resolution MRI and had confirmed histopathological diagnosis of rectal cancer located within 15 cm from the anal verge, followed by surgery. MRI findings were compared with pathological and surgical results.

Results: The overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI-based T-staging were 92.8, 88.8%, 96.5%, 96%, and 90.3%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based assessment of CRM were 94.6%, 84.6%, 97.6%, 91.4, and 94.6%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively.

Conclusions: Preoperative high-resolution rectal MRI is accurate in predicting tumor stage and CRM involvement. MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery.

No MeSH data available.


Related in: MedlinePlus