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Value of ADC measurements for nodal staging after chemoradiation in locally advanced rectal cancer-a per lesion validation study.

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 *10⁻³ 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.

journal_name

Eur Radiol

journal_title

European radiology

authors

Lambregts DM,Maas M,Riedl RG,Bakers FC,Verwoerd JL,Kessels AG,Lammering G,Boetes C,Beets GL,Beets-Tan RG

doi

10.1007/s00330-010-1937-x

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

265-73

issue

2

eissn

0938-7994

issn

1432-1084

journal_volume

21

pub_type

临床试验,杂志文章

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