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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.

[1]
Allen SD, Padhani AR, Dzik Jurasz AS, et al. Rectal carcinoma: MRI with histologic correlation before and after chemoradiation therapy. AJR Am J Roentgenol, 2007, 88(2): 442-451.
[2]
Kulkarni T, Gollins S, Maw A, et al. Magnetic resonance imaging in rectal cancer downstaged using neoadjuvant chemoradiation: accuracy of prediction of tumour stage and circumferential resection margin status. Colorectal Dis, 2008, 10(5): 479-489.
[3]
Hancock L, Forde C, Bradbury J, et al. Magnetic resonance imaging predicts circumferential resection margin status in patients receiving preoperative chemoradiotherapy for rectal cancer. Colorectal Dis, 2006, 8(9): 816.
[4]
Chen DW. Preoperative judgment of local invasion of rectal carcinoma. Chin J Dig Surg,2002,1(3):160-162
[5]
Hussain SM, Outwater EK, Siegelman ES. Mucious versus nonmucinous rectal carcinomas: differentiation with MR imaging. Radiology, 1999, 213: 79-85.
[6]
Ren J, Huan Y, Zhao HT, et al. Differential diagnosis between benign prostatic hyperplasia and carcinoma by dynamic contrast-enhanced MR imaging signal intensity-time curve. J Pract Radiol,2006,22(9):1111-1114.
[7]
Cai XR, Chen DH, Jiang GY, et al. Colorectal carcinoma: a preliminary study on magnetic resonance imaging. Chin J Radiol, 2003,37(5):427-427.
[8]
Wu CQ, Yang BL, Gu YF. Diagnosis on the preoperative staging of rectal cancer by magnetic resonance imaging with water-bag in rectum. Chin J Gastrointestinal Surg, 2008, 11(3): 246-248.
[9]
Zhang XM, Zhang HL, Yu D, et al. 3-T MRI of rectal carcinoma: preoperative diagnosis, staging, and planning of sphincter-sparing surgery. AJR Am J Roentgenol, 2008, 190(5): 1271-1278.
[10]
Mathur P, Smith JJ, Ramsey C, et al. Comparison of CT and MRI in the preoperative staging of rectal adenocarcinoma and prediction of circumferential resection margin involvement by MRI. Colorectal Dis, 2003, 5(5): 396-401.
[11]
Kusunoki M, Yanagi H, Kamikonya N, et al. Preoperative detection of local extension of carcinoma of the rectum using magnetic resonance imaging. J Am Coll Surg, 1994, 179(6): 653-656.
[12]
Schnall MD, Furth EE, Rosato EF, et al. Rectal tumor stage: correlation of endorectal MR imaging and pathologic findings. Radiology, 1994, 190(3): 709-714.
[13]
Okizuka H, Sugimura K, Yoshizako T, et al. Rectal carcinoma: prospective comparison of conventional andgadopentetate dimeglumine enhanced fat-suppressed MR imaging. J Magn Reson Imaging, 1996, 6(3): 465-471.
[14]
Indinnimeo M, Grasso RF, Cicchini C, et al. Endorectal magnetic resonance imaging in the preoperative staging of rectal tumors. Int Surg, 1996, 81(4): 419-422.
[15]
Zerhouni EA, Rutter C, Hamilton SR, et al. CT and MR imaging in the staging of colorectal carcinoma: report of the Radiology Diagnostic Oncology Group II. Radiology, 1996, 200(2): 443-451.
[16]
Dworak O. Morphology of lymph nodes in the resected rectum of patients with rectal carcinoma. Pathol Res Pract, 1991, 187(8): 1020-1024.
[17]
Brown G, Richards CJ, Bourne MW, et al. Morphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison. Radiology, 2003, 227(2): 371-377.
[18]
Habr-Gama A, Perez RO, Nadalin W, et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg, 2004, 240: 711-717; DOI: .
[19]
Yu BM. Progress in the diagnosis and treatment of lower rectal cancer. Chin J Pract Surg, 2002, 22(1): 34-37.
[20]
Xiao Y, Wu B, Lin GL, et al. Management of complete response after neoadjuvant therapy in mid-low rectal cancer. Chin J Pract Surg, 2008,28(5):362-363.
[21]
NakagawaWT, Rossi BM, de Ferreira F, et al. Chemoradiation instead of surgery to treatmid and low rectal tumors: Is it safe? Ann Surg Oncol, 2002, 9(6): 568-573.
[22]
Hiotis SP, Weber SM, Cohen AM, et al. Assessing the p redictive value of clinical comp lete response to neoadjuvant therapy for rectal cancer: an analysis of 488 patients. J Am Coll Surg, 2002, 194(2): 131-135.

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