Magnetic resonance imaging as a tool to predict pathological complete response of rectal cancer after neoadjuvant chemoradiotherapy: a Meta-analysis

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• Clinical Article •

LI Jipin MAO Lei ZHOU Xueting MA Wenli XIE Zhuanhong WANG Xiang

Cite this article as: Li JP, Mao L, Zhou XT, et al. Magnetic resonance imaging as a tool to predict pathological complete response of rectal cancer after neoadjuvant chemoradiotherapy: a Meta-analysis. Chin J Magn Reson Imaging, 2020, 11(11): 1010-1018. DOI:10.12015/issn.1674-8034.2020.11.011.

Abstract

[Abstract] Objective: The aim of this study was to evaluate the predictive effect of MRI on the pathological complete response (pCR) of rectal cancer after neoadjuvant chemoradiotherapy.Materials and Methods: Comprehensive computer-based search was performed (last updated in June 2020), and the eligible studies were selected. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR) and the area under the hierarchical summary receiver-operating characteristic curves (AUC) were calculated to estimate the diagnostic accuracy of MRI. Methodological quality was assessed using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool.Results: Thirty five studies with 2674 patients were included and analyzed. The results showed that pooled sensitivity, specificity of MRI were [0.75, 95% CI (0.70, 0.80)] and [0.86, 95% CI (0.82, 0.89)], respectively. Among the different sequences, diffusional kurtosis imaging had the highest sensitivity with the odds ratio (OR) of 0.84 (95% CI: 0.73, 0.91). T2-weighted imaging with dynamic contrast enhanced had the highest specificity than other sequences [0.96, 95% CI (0.89, 0.99)]. In addition, T2-weighted imaging with diffusion weighted imaging was associated with the highest DOR [47.56, 95% CI (23.64, 95.72)] and AUC [0.94, 95% CI (0.92, 0.96)]. The indirect comparison also showed T2-weighted imaging with diffusion weighted imaging was the best sequence to diagnose pCR. 1.5 T and 3.0 T were similar in sensitivity, specificity and AUC results.Conclusions: T2-weighted imaging with diffusion weighted imaging is superior to other sequences of MRI, and is the optimal choice for the diagnosis of the pCR of rectal cancer. Besides, there is no difference in the prediction effect of different magnetic intensities.

[Keywords] Rectal neoplasms；magnetic resonance imaging；pathological complete response；treatment evaluation；Meta-analysis；indirect comparison；diagnostic test

Contributor Information

LI Jipin The Second Clinical Medical College, Lanzhou University, Lanzhou 730000, China

MAO Lei The Second Clinical Medical College, Lanzhou University, Lanzhou 730000, China

ZHOU Xueting The Second Clinical Medical College, Lanzhou University, Lanzhou 730000, China

MA Wenli The Second Clinical Medical College, Lanzhou University, Lanzhou 730000, China

XIE Zhuanhong The Second Clinical Medical College, Lanzhou University, Lanzhou 730000, China

WANG Xiang^* Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou 730030, China

*Correspondence to: Wang X, E-mail: wangxiang@lzu.edu.cn

Conflicts of interest None.

Publication Information

Received 2020-05-22

Accepted 2020-09-28

DOI: 10.12015/issn.1674-8034.2020.11.011

Text

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