Rectal cancer lexicon: consensus statement from the society of abdominal radiology rectal &amp; anal cancer disease-focused panel

Hope, Thomas A.; Gollub, Marc J.; Arya, Supreeta; Bates, ‬David D. B.; Ganeshan, Dhakshinamoorthy; Harisinghani, Mukesh G.; Jhaveri, Kartik; Kassam, Zahra; Kim, David H.; Korngold, Elena K.; Lalwani, Neeraj; Moreno, Courtney C.; Nougaret, Stéphanie; Paroder, Viktoriya; Paspulati, Raj Mohan; Pernicka, Jennifer S. Golia; Petkovska, Iva; Pickhardt, Perry J.; Rauch, Gaiane M.; Rosenthal, Michael H.; Sheedy, Shannon P.; Horvat, Natally

doi:10.1007/s00261-019-02170-5

Cited by 22 publications

(13 citation statements)

References 40 publications

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“…Post‐CRT pTRG predicts OS and is considered to be an important prognostic predictor for DFS. Post‐CRT mrTRG, which follows the principles of pTRG, has been developed 15 . This system potentially provides an opportunity to consider salvage preoperative treatments if satisfactory tumour regression is not achieved with standard therapy, or the adoption of a non‐operative management strategy if CR with no active residual cancer is diagnosed.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative concurrent chemoradiotherapy MRI characteristics favouring pathologic complete response in patients with rectal cancer: Usefulness of MR T2‐stage as an ancillary finding for predicting pathologic complete response

Lee

Chung

2020

J Med Imag Rad Onc

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Introduction This study sought to assess preoperative concurrent chemoradiotherapy (CRT) magnetic resonance imaging (MRI)‐based findings according to a structured MRI report template for primary staging of rectal cancer, and to evaluate the prognostic relevance of the pre‐CRT MRI‐based findings in patients with rectal cancer after CRT. Methods We retrospectively evaluated pre‐ and post‐CRT MRI data of patients with pathologically proven rectal adenocarcinoma, between January 2008 and October 2019. Image interpretation was performed independently by two radiologists and each reviewer assessed the cancer characteristics on MRI, based on the structured MRI report for primary staging. MRI‐based findings associated with pathologic complete tumour regression grade (TRG) after CRT were analysed by univariate and multivariate analysis. Significant factors from pre‐CRT MRI were weighted to score mrTRG in post‐CRT MRI. Results On univariate analysis, MR T‐stage, tumour infiltration, mesorectal fascia involvement, extramural vascular invasion and serum carcinoembryonic antigen level correlated significantly with pathologic complete response (pCR). Multivariate analysis identified that only MR T‐stage was independently associated with pCR (odds ratio, 3.89, 95% confidence interval, 1.18–12.84; P = 0.0278). Adding MRI‐based T2‐stage as an ancillary finding to mrTRG statistically significantly improved the sensitivity as compared to using only mrTRG for considering a CR. T2_mrTRG was significantly different in terms of the time to tumour progression between the CR and non‐CR group. Conclusions The MR T2‐stage was independently associated with pCR after CRT in patients with rectal cancer and was helpful as ancillary predictive factor, adding to mrTRG for prediction of pCR.

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Section: Discussionmentioning

confidence: 99%

“…On rectal MRI, three layers of the rectal wall are mostly visible as follows: mucosa, as the innermost, thin, hypointense layer; submucosa, as middle, hyperintense layer; and the muscularis propria, as the outer, hypointense layer 13 . MR T2‐stage defines that the tumour extends to involve the muscularis propria.…”

Section: Methodsmentioning

confidence: 99%

Preoperative concurrent chemoradiotherapy MRI characteristics favouring pathologic complete response in patients with rectal cancer: Usefulness of MR T2‐stage as an ancillary finding for predicting pathologic complete response

Lee

Chung

2020

J Med Imag Rad Onc

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“…54 , 55 In general, locoregional (N stage) nodes include mesorectal, inferior mesenteric and superior rectal, internal iliac and obturator lymph nodes. 55 Anatomically, the internal iliac and obturator nodes are both locoregional and lateral pelvic sidewall nodes. The internal iliac nodes are situated medial to the internal iliac artery and the obturator is lateral at the level of the obturator muscle.…”

Section: Lymph Nodesmentioning

confidence: 99%

“…The internal iliac nodes are situated medial to the internal iliac artery and the obturator is lateral at the level of the obturator muscle. 55 Nonlocoregional (pelvic side wall + distant or M1) lymph nodes associated with rectal cancer include inguinal, external iliac, common iliac, and periaortic nodes. 52 , 55 The presence of a suspicious locoregional lymph node (N + /stage III disease) is sufficient evidence to initiate neoadjuvant therapy, irrespective of the T stage.…”

Section: Lymph Nodesmentioning

confidence: 99%

MRI for Rectal Cancer: Staging, mrCRM, EMVI, Lymph Node Staging and Post-Treatment Response

Bates

Homsi

Chang

et al. 2022

Clinical Colorectal Cancer

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“…Some preliminary studies have examined DECT as an imaging biomarker for Ki-67 proliferation index in rectal cancer and gastric cancer. In one retrospective study, the normalized iodine concentration (NIC) (14) value derived from DECT imaging of a rectal lesion was positively correlated with the expression of Ki-67 and hypoxia-inducible factor 1α (HIF-1α), suggesting that DECT imaging could be a noninvasive method for predicting tumor cell proliferation and hypoxia in rectal cancer (13). Another study demonstrated a positive correlation between curve slope (λ HU ), iodine concentration (IC), and NIC values derived from DECT imaging of gastric lesions and Ki-67 expression (15).…”

Section: Introductionmentioning

confidence: 99%

Initial evaluation of dual-energy computed tomography as an imaging biomarker for hepatic metastases from neuroendocrine tumor of the gastrointestinal tract

Cruz-Hernández¹,

Mahmood²,

Pernicka³

et al. 2021

Quant Imaging Med Surg

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Background: To evaluate quantitative iodine parameters from the arterial phase dual-energy computed tomography (DECT) scans as an imaging biomarker for tumor grade (TG), mitotic index (MI), and Ki-67 proliferation index of hepatic metastases from neuroendocrine tumors (NETs) of the gastrointestinal (GI) tract. Imaging biomarkers have the potential to provide relevant clinical information about pathologic processes beyond lesion morphology. NETs are a group of rare, heterogeneous neoplasms classified by World Health Organization (WHO) TG, which is derived from MI and Ki-67 proliferation index. Imaging biomarkers for these pathologic features and TG may be useful.Methods: Between January 2014 and April 2019, 73 unique patients with hepatic metastases from NET of the GI tract underwent DECT of the abdomen with an arterial phase were analyzed after exclusions.Using GSIViewer software (GE Healthcare, Madison, Wisconsin), elliptical regions of interest (ROIs) were placed over selected hepatic metastases by a fellowship trained abdominal radiologist. Quantitative iodine concentration (IC) data was extracted from the lesion ROIs, and the normalized IC (lesion IC/aorta IC) and relative IC (lesion IC/liver IC) for each liver were calculated. Spearman correlation was calculated for lesion mean IC, normalized IC, and relative IC to both Ki-67 proliferation and mitotic indices. Student's t-test was performed to compare lesion mean IC, normalized IC and relative IC between WHO TGs.Results: There was very weak correlation between both normalized IC and relative IC for both Ki-67 proliferation and mitotic indices. A significant difference was not observed between normalized IC and relative IC to distinguish metastases from G1 and G2/3 tumors. Conclusions:Our study finds limited potential for quantitative parameters from DECT to distinguish neuroendocrine hepatic metastases by WHO TG, as well as limited potential as an imaging biomarker for Ki-67 proliferation and mitotic indices in this setting. Our findings of a lack of correlation between Ki-67 and quantitative iodine parameters stands in contrast to existing literature that reports positive correlations for these parameters in the rectum and stomach.

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Rectal cancer lexicon: consensus statement from the society of abdominal radiology rectal & anal cancer disease-focused panel

Cited by 22 publications

References 40 publications

Preoperative concurrent chemoradiotherapy MRI characteristics favouring pathologic complete response in patients with rectal cancer: Usefulness of MR T2‐stage as an ancillary finding for predicting pathologic complete response

Preoperative concurrent chemoradiotherapy MRI characteristics favouring pathologic complete response in patients with rectal cancer: Usefulness of MR T2‐stage as an ancillary finding for predicting pathologic complete response

MRI for Rectal Cancer: Staging, mrCRM, EMVI, Lymph Node Staging and Post-Treatment Response

Initial evaluation of dual-energy computed tomography as an imaging biomarker for hepatic metastases from neuroendocrine tumor of the gastrointestinal tract

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