Prediction of Nodal Involvement in Primary Rectal Carcinoma without Invasion to Pelvic Structures: Accuracy of Preoperative CT, MR, and DWIBS Assessments Relative to Histopathologic Findings

Zhou, Jun; Zhan, Songhua; Gong, Huan; Wang, Yidong; Fan, Desheng; Gong, Zhigang; Huang, Yanwen

doi:10.1371/journal.pone.0092779

Cited by 22 publications

(14 citation statements)

References 31 publications

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“…It is difficult for radiologists to make correct and timely judgements based on all the factors above in a short period of time, especially when they are faced with a large number of cases. Therefore, different radiologists can reach different conclusions from the same MRI image; in particular, it is difficult to obtain an accurate and objective evaluation of lymph node metastasis (2)(3)(4)(5). Currently, the diagnostic criteria for metastatic lymph nodes are not identical, and lymph node size is taken as the diagnostic criteria in most cases; however, there has been no agreed-upon conclusion on the size threshold for metastatic lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

Identification of Metastatic Lymph Nodes in MR Imaging with Faster Region-Based Convolutional Neural Networks

Lu¹,

Yu²,

Gao

et al. 2018

Cancer Research

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MRI is the gold standard for confirming a pelvic lymph node metastasis diagnosis. Traditionally, medical radiologists have analyzed MRI image features of regional lymph nodes to make diagnostic decisions based on their subjective experience; this diagnosis lacks objectivity and accuracy. This study trained a faster region-based convolutional neural network (Faster R-CNN) with 28,080 MRI images of lymph node metastasis, allowing the Faster R-CNN to read those images and to make diagnoses. For clinical verification, 414 cases of rectal cancer at various medical centers were collected, and Faster R-CNN-based diagnoses were compared with radiologist diagnoses using receiver operating characteristic curves (ROC). The area under the Faster R-CNN ROC was 0.912, indicating a more effective and objective diagnosis. The Faster R-CNN diagnosis time was 20 s/case, which was much shorter than the average time (600 s/case) of the radiologist diagnoses. Faster R-CNN enables accurate and efficient diagnosis of lymph node metastases. .

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Section: Introductionmentioning

confidence: 99%

Identification of Metastatic Lymph Nodes in MR Imaging with Faster Region-Based Convolutional Neural Networks

Lu¹,

Yu²,

Gao

et al. 2018

Cancer Research

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“…Similarly, Roy et al reported no significant difference between the median ADC value of metastatic LNs and non-metastatic LNs in the pelvic LNs of gynecological malignancies [ 48 ]. Additionally, Zhou et al reported that the sensitivity and negative predictive values for DWI were 100%, with an accuracy for DWI of only 40.4%, and they argued that DWI is currently unlikely to be useful in clinical practice due to its low accuracy [ 49 ]. There still remains controversy, and further investigation is needed regarding the application of the DWI and ADC values for discriminating between metastatic and benign lymph nodes, including LPLNs of advanced rectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Prediction of lateral pelvic lymph node metastasis in patients with locally advanced rectal cancer with preoperative chemoradiotherapy: Focus on MR imaging findings

Kim¹,

Hur²,

Lee³

et al. 2018

PLoS ONE

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PurposeTo investigate the predictive factors for lateral pelvic lymph node (LPLN) metastasis in patients with locally advanced rectal cancer treated with preoperative chemoradiotherapy (CRT).Materials and methodsFifty-seven patients with locally advanced rectal cancer and LPLNs larger than 5 mm underwent LPLN dissection (LPLD) after preoperative CRT. The MRI findings, including the apparent diffusion coefficient value and LPLN size reduction rate before/after CRT; clinical factors; and pathologic results were evaluated to identify the predictive factors associated with LPLN metastasis.ResultsLPLN metastasis was confirmed in 23 patients (40.4%). Metastasis was significantly higher in LPLNs with multiplicity, short-axis diameter ≥8 mm before CRT, short-axis diameter >5 mm after CRT, size reduction rate ≤33.3%, heterogeneous signal intensity, and irregular margin (P<0.05) on MR. Multivariable analysis showed that pre-CRT short-axis diameter of LPLNs ≥8 mm, size reduction rate ≤33.3%, and heterogeneous signal intensity were independently associated with LPLN metastasis.ConclusionsThe size and signal intensity of LPLN before and after CRT are useful MRI findings to predict LPLN metastasis and are helpful to determine the indications for LPLD.

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“…Prediction of nodal staging in patients with primary rectal carcinoma is important for prognosis, and preoperative assessment of lymph node involvement has important value in developing the therapeutic schedule and a new auxiliary treatment (22). CT criteria for metastatic lymph nodes included size, border, shape and enhancement.…”

Section: Discussionmentioning

confidence: 99%

Local staging of rectal cancer: Diagnostic potential of endorectal contrast agent and MPRs with 64-MDCT compared with the pathologic staging

Abdel-Gawad

Wahab

Afifi³

et al. 2015

The Egyptian Journal of Radiology and Nuclear Medicine

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Purpose: To assess the diagnostic potential of endorectal contrast agent and multiplanar reconstructed images (MPRs) with MDCT in local staging of rectal cancer compared with the pathologic staging. Patients and methods: This study included 30 patients with biopsy-proven rectal cancer (age range 18-84 years, mean 46.7 ± 19). Preoperative MDCT examinations were performed to all patients using a 64-row multidetector scanner. The examination was carried out in two steps, firstly using oral contrast agent only, secondly using endorectal contrast agent. Images were reconstructed in axial, coronal, and sagittal planes. MDCT staging was compared with pathologic staging. Results: For T-staging, MDCT using endorectal contrast was more sensitive (75.8%), specific (90%) and accurate (86.7%) than using oral contrast only (43.3%, 88.1%, 74.4%) respectively (p = 0.001). The sagittal and coronal MPRs were more sensitive, specific and accurate than the axial images with diagnostic accuracy 64.4% for axial, 75.5% for coronal, and 81.1% for sagittal MPRs. There were statistically significant differences between axial and coronal MPRs (p = 0.02), and between axial and sagittal MPRs (p = 0.002). Diagnostic accuracy for N-staging was 80%. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Conclusion: 64-MDCT with endorectal contrast agent and MPRs, mainly sagittal images is a reliable accurate technique for the preoperative local staging of rectal cancer.

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Prediction of Nodal Involvement in Primary Rectal Carcinoma without Invasion to Pelvic Structures: Accuracy of Preoperative CT, MR, and DWIBS Assessments Relative to Histopathologic Findings

Cited by 22 publications

References 31 publications

Identification of Metastatic Lymph Nodes in MR Imaging with Faster Region-Based Convolutional Neural Networks

Identification of Metastatic Lymph Nodes in MR Imaging with Faster Region-Based Convolutional Neural Networks

Prediction of lateral pelvic lymph node metastasis in patients with locally advanced rectal cancer with preoperative chemoradiotherapy: Focus on MR imaging findings

Local staging of rectal cancer: Diagnostic potential of endorectal contrast agent and MPRs with 64-MDCT compared with the pathologic staging

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