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• Clinical Article •
Effects of neoadjuvant chemoradiotherapy prior to surgery on rectal cancer assessing by DCE-MRI
ZHOU Ni-na  CHEN Min  WANG Wen-chao  ZHAO Wei-feng  YANG Zheng-han  LI Sa-ying  ZHANG Chen 

DOI:10.3969/j.issn.1674-8034.2010.02.005.


[Abstract] Objective: To evaluate dynamic contrast-enhanced MR imaging (DCE-MRI) in assessing pathologic responses in rectal cancer treated with neoadjuvant chemoradiotherapy (NCRT), and to compare the diagnostic accuracy of T2WI and DCE-MRI in the preoperative T and N staging of rectal cancer.Materials and Methods: Forty patients with pathologically proven primary rectal cancer were enrolled in this study, 18 patients had no preoperative treatments, 22 patients treated with NCRT. DCE-MRI was performed in all patients on GE 1.5 T Twinspeed HD MR scanner. The rectal cancer stage was made according to the TNM classification criteria. Preoperative MRI assessment was compared with postoperative histopathological findings. Parameters of DCE-MRI curves including type of enhancement, the time of maximum uptake, the uptake velocity T, were analyzed. The normal rectum part was selected as control.Results: (1) For rectal cancer without NCRT, DCE-MRI had an accuracy of 83.3% for T staging, and T2WI had an accuracy of 66.7%. For predicting a clear circumferential resection margin (CRM), DCE-MRI had an accuracy of 88.2%, and T2WI had an accuracy of 70.7%. Lymph nodes of diameter more than 2 mm could be found in DCE-MRI and T2WI. (2) For rectal cancer treated with NCRT, DCE-MRI had an accuracy of 86.4% for T staging and 81.8% for N staging in preoperative tumor restaging, and had an accuracy of 100% for predicting a clear CRM. However, T2WI could not distinguish stages for the tumor. (3) The T value of the lesions was equal to or lower than the normal rectum part in pathologic complete response (PCR) group, while the T value of the lesions was higher than normal rectum part in non-PCR group.Conclusion: DCE-MRI has high accuracy for preoperative tumor restaging, and play an important role for predicting circumferential resection margin status of rectal cancer treated with NCRT.
[Keywords] Rectal neoplasms；Magnetic resonance imaging, dynamic contrast-enhanced；Neoadjuvant therapy；Neoplasm staging

ZHOU Ni-na Department of Radiology, Beijing Hospital, Beijing 100730, China

CHEN Min* Department of Radiology, Beijing Hospital, Beijing 100730, China

WANG Wen-chao Department of Radiology, Beijing Hospital, Beijing 100730, China

ZHAO Wei-feng Department of Radiology, Beijing Hospital, Beijing 100730, China

YANG Zheng-han Department of Radiology, Beijing Hospital, Beijing 100730, China

LI Sa-ying Department of Radiology, Beijing Hospital, Beijing 100730, China

ZHANG Chen Department of Radiology, Beijing Hospital, Beijing 100730, China

*Correspondence to: Chen M, E-mail: chenmin62@yahoo.com

Conflicts of interest   None.

Received  2010-01-16
Accepted  2010-03-08
DOI: 10.3969/j.issn.1674-8034.2010.02.005
DOI:10.3969/j.issn.1674-8034.2010.02.005.

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