Morphologic Predictors of Lymph Node Status in Rectal Cancer with Use of High-Spatial-Resolution MR Imaging with Histopathologic Comparison

Brown, Gina; Richards, C. J.; Bourne, Michael W.; Newcombe, Robert G.; Radcliffe, A. G.; Dallimore, N S; Williams, Geraint T.

doi:10.1148/radiol.2272011747

Cited by 757 publications

(469 citation statements)

References 21 publications

Supporting

Mentioning

430

Contrasting

Unclassified

Order By: Relevance

“…At DRE the tumors are found clinically tethered or fixed in 78.4% of the cases. As neither TRUS nor CT could -at that time-provide sufficiently reliable information on clinical N-stage (cN), this variable is not analyzed [23,24].…”

Section: Resultsmentioning

confidence: 99%

Effect of timing of surgery on survival after preoperative hyperfractionated accelerated radiotherapy (HART) for locally advanced rectal cancer (LARC): Is it a matter of days?

et al. 2006

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

Effect of timing of surgery on survival after preoperative hyperfractionated accelerated radiotherapy (HART) for locally advanced rectal cancer (LARC): Is it a matter of days?

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Furthermore, retrospective data have suggested that a combined modality therapy could represent an overtreatment in patients at low risk of local failure after TME alone, such as some tumours staged as T3N0 (Willett et al, 1999). In this setting, MRI plays a key role, because it can predict the CRM involvement (Beets-Tan et al, 2000), so defining the patients at higher risk of local recurrence when treated with TME plus RT (Marijnen et al, 2003), although it has been demonstrated less sensitive and specific at identifying nodal disease and vascular invasion (Brown et al, 2003;Branagan et al, 2004). Our phase I -II study was carried out in patients with LARC at high risk of recurrence, as identified by both EUS and MRI.…”

Section: Discussionmentioning

confidence: 99%

Biweekly oxaliplatin, raltitrexed, 5-fluorouracil and folinic acid combination chemotherapy during preoperative radiation therapy for locally advanced rectal cancer: a phase I–II study

et al. 2006

View full text Add to dashboard Cite

Oxaliplatin (OXA), raltitrexed (RTX), 5-fluorouracil (FU) and folinic acid (FA) have shown activity in metastatic colorectal cancer, radioenhancing effect and synergism when combined. We evaluated a chemotherapy (CT) combination of OXA, RTX and FU/FA during preoperative radiotherapy (RT) in locally advanced rectal cancer (LARC) patients. Fifty-one patients with LARC at high risk of recurrence (T4, N þ or T3N0 p5 cm from anal verge and/or circumferential resection margin p5 mm) received three biweekly courses of CT during pelvic RT (45 Gy). Surgery was planned 8 weeks after CT-RT. Recommended doses (RDs) determined during phase I were utilised in the subsequent phase II trial, where the rate of tumour regression grade (TRG) 1 or 2 was the main end point. No toxic deaths occurred, and severe toxicity was easily managed. In phase II, RDs delivered in 31 patients were OXA 100 mg m À2 and RTX 2.5 mg m À2 on day 1, and FU 900 mg m À2 and LFA 250 mg m À2 on day 2. Main severe toxicities by patients were grade 4 neutropenia (23%) and grade 3 diarrhoea (19%). In 71% (95% confidence limits, 52 -86%) of patients, TRG1 (13) or TRG2 (9) was obtained. All patients are alive and recurrence-free after a median follow-up of 29 months. Combination of OXA, RTX and FU/FA with pelvic RT has an acceptable toxicity and a high clinical activity in LARC and should be studied further in patients at high risk of recurrence.

show abstract

“…However, a limitation remains in differentiating metastatic nodes from normal lymph nodes on the basis of size alone (33). The lymph node shape, signal intensity characteristics, and enhancement pattern may be used to identify lymph node involvement with tumor (34). However, these results are preliminary and require further investigation.…”

Section: Discussionmentioning

confidence: 99%

Local staging of rectal cancer using combined pelvic phased‐array and endorectal coil MRI

Tatlı

Mortelé

Breen

et al. 2006

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose:To assess the accuracy of MRI, using a pelvic phased-array coil and an endorectal coil, for preoperative local staging of rectal cancer. Materials and Methods:Fifty-one patients (26 males and 25 females) with adenocarcinoma of the rectum underwent preoperative MRI and surgical resection of their tumors. Surgical pathology staging was compared to MRI staging (using the TNM classification) obtained both retrospectively by a reader blinded to surgical findings and prospectively (radiological reports). In addition, patients were stratified according to surgical treatment groups (stage I ϭ T1-2/N0, stage II ϭ T3/N0, stage III ϭ Tx/N1-2).Results: At pathology, 36 of 51 (68%) tumors were classified as T0-T2, and 15 (32%) were classified as T3. Overall, the sensitivity and specificity of MRI readings for T3 staging were 93% and 86%, respectively (positive predictive value (PPV) ϭ 74%, negative predictive value (NPV) ϭ 97%, accuracy ϭ 88%). MRI correctly predicted lymph node metastases in 11 of 13 patients with a sensitivity of 85% and specificity of 69% (PPV ϭ 58%, NPV ϭ 90%, accuracy ϭ 74%). MRI correctly predicted surgical treatment groups in 33 of 39 (85%) patients. Interobserver agreement between the retrospective and prospective readings was excellent ( ϭ 0.85) for prediction of T3 tumor and good ( ϭ 0.80) for prediction of nodal involvement. Conclusion:Combined endorectal and pelvic phased-array coil MRI can be used reliably to select which patients should receive preoperative chemoradiotherapy. It is highly predictive in terms of excluding T3 tumors, but still has limitations in predicting lymph node metastasis.

show abstract

Morphologic Predictors of Lymph Node Status in Rectal Cancer with Use of High-Spatial-Resolution MR Imaging with Histopathologic Comparison

Abstract: Prediction of nodal involvement in rectal cancer with MR imaging is improved by using the border contour and signal intensity characteristics of lymph nodes instead of size criteria.

Cited by 757 publications

References 21 publications

Effect of timing of surgery on survival after preoperative hyperfractionated accelerated radiotherapy (HART) for locally advanced rectal cancer (LARC): Is it a matter of days?

Effect of timing of surgery on survival after preoperative hyperfractionated accelerated radiotherapy (HART) for locally advanced rectal cancer (LARC): Is it a matter of days?

Biweekly oxaliplatin, raltitrexed, 5-fluorouracil and folinic acid combination chemotherapy during preoperative radiation therapy for locally advanced rectal cancer: a phase I–II study

Local staging of rectal cancer using combined pelvic phased‐array and endorectal coil MRI

Contact Info

Product

Resources

About