Value of MRI and diffusion-weighted MRI for the diagnosis of locally recurrent rectal cancer.

D.M. Lambregts, V.C. Cappendijk, M. Maas, G.L. Beets, R.G.H. Beets-Tan

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Abstract

OBJECTIVES: To evaluate the accuracy of standard MRI, diffusion-weighted MRI (DWI) and fusion images for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence. METHODS: Forty-two patients with a clinical suspicion of recurrence underwent 1.5-T MRI consisting of standard T2-weighted FSE (3 planes) and an axial DWI (b0,500,1000). Two readers (R1,R2) independently scored the likelihood of recurrence; [1] on standard MRI, [2] on standard MRI+DWI, and [3] on T2-weighted+DWI fusion images. RESULTS: 19/42 patients had a local recurrence. R1 achieved an area under the ROC-curve (AUC) of 0.99, sensitivity 100% and specificity 83% on standard MRI versus 0.98, 100% and 91% after addition of DWI (p = 0.78). For R2 these figures were 0.87, 84% and 74% on standard MRI and 0.91, 89% and 83% with DWI (p = 0.09). Fusion images did not significantly improve the performance. Interobserver agreement was kappa0.69 for standard MRI, kappa0.82 for standard MRI+DWI and kappa0.84 for the fusion images. CONCLUSIONS: MRI is accurate for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence. Addition of DWI does not significantly improve its performance. However, with DWI specificity and interobserver agreement increase. Fusion images do not improve accuracy.
Original languageEnglish
Pages (from-to)1250-1258
Number of pages9
JournalEuropean Radiology
Volume21
Issue number6
DOIs
Publication statusPublished - Jun 2011

Keywords

  • MRI
  • Diffusion magnetic resonance imaging
  • Rectal neoplasms
  • Local neoplasm recurrence
  • Diagnosis
  • POSITRON-EMISSION-TOMOGRAPHY
  • COLORECTAL-CANCER
  • FOLLOW-UP
  • PREOPERATIVE CHEMORADIATION
  • HISTOPATHOLOGIC FINDINGS
  • CARCINOMA
  • THERAPY
  • PET/CT
  • BODY
  • CT

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