Selection of Lymph Node–Positive Cases Based on Perirectal and Lateral Pelvic Lymph Nodes Using Magnetic Resonance Imaging: Study of the Japanese Society for Cancer of the Colon and Rectum

Ogawa, Shimpei; Hida, Jin‐ichi; Ike, Hideyuki; Kinugasa, Tetsushi; Ota, Mitsuyoshi; Shinto, Eiji; Itabashi, Michio; Kameoka, Shingo; Sugihara, Kenichi

doi:10.1245/s10434-015-5021-2

Cited by 74 publications

(47 citation statements)

References 19 publications

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“…11). On the other hand, large lymph nodes such as ≥ 8 mm in short-axis diameter (56), ≥ 10 mm in short-axis diameter (57) or ≥ 10 mm in maximal diameter (54) were reported to be highly specific for nodal metastasis, albeit not sensitive. The Canadian guide for reporting of rectal cancer MRI (56) provides specific instructions regarding lymph node size that should be reported to be suspicious of metastasis, i.e., ≥ 8 mm and ≥ 10 mm in short-axis diameter for mesorectal and extramesorectal nodes, respectively.…”

Section: Elaboration On the Reporting Items Formats And Their Clinimentioning

confidence: 99%

Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

2017

Korean J Radiol

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High-resolution rectal MRI plays a crucial role in evaluating rectal cancer by providing multiple prognostic findings and imaging features that guide proper patient management. Quality reporting is critical for accurate effective communication of the information among multiple disciplines, for which a systematic structured approach is beneficial. Existing guides on reporting of rectal MRI are divergent on some issues, largely reflecting the differences in overall management of rectal cancer patients between the United States and Europe. The Korean Society of Abdominal Radiology (KSAR) study group for rectal cancer has developed an expert consensus recommendation regarding essential items for structured reporting of rectal cancer MRI using a modified Delphi method. This recommendation aims at presenting an up-to-date, evidence-based, practical, structured reporting template that can be readily adopted in daily clinical practice. In addition, a thorough explanation of the clinical and scientific rationale underlying the reporting items and their formats is provided. This KSAR recommendation may serve as a useful tool to help achieve more standardized optimal care for rectal cancer patients using rectal MRI.

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Section: Elaboration On the Reporting Items Formats And Their Clinimentioning

confidence: 99%

Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

2017

Korean J Radiol

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“…A recent meta-analysis reported that the sensitivity and specificity of MRI for diagnosis of pararectal and/or mesenteric lymph node metastasis of rectal cancer were 77% and 71%, respectively [6]. Regarding the pre-operative diagnosis of LPLN metastasis ability, five Japanese imaging studies using MRI and/or (MD) CT have been published (Table 4) [7][8][9][10][11]. The studies using MRI showed that the sensitivity, specificity, PPV, NPV, and accuracy were in the range of 43.8%-87%, 79.7%-98.5%, 43.6%-91%, 81%-97%, and 77.6%-88.1%, respectively, using a size criteria ranging from 4 to 10 mm at the short axis.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent meta-analysis, the sensitivity and specificity of MRI for the lymph node metastasis diagnosis were reported to be 77% and 71%, respectively [6], but this study only examined the perirectal (mesorectal) lymph nodes. Several studies from Japan reported the diagnostic value of MRI for the detection of LPLN metastasis in LRC without pre-operative therapy [7][8][9][10][11]. According to these studies, the sensitivity and specificity of MRI for the detection of LPLN metastasis were ranging between 43.8%-87% and 79.7%-98.5%, respectively.…”

Section: Introductionmentioning

confidence: 99%

“…The size criteria for LPLN metastasis detection has not been fully examined for MRI and CT imaging. Previous studies reported that the cut-off value of LPLN metastasis ranged between 4 and 10 mm [7][8][9][10][11]. In the JCOG0212 trial, lymph nodes with a short-axis diameter of <10 mm as seen by CT or MRI imaging were defined as negative for detecting LPLN metastasis [2].…”

Section: Introductionmentioning

confidence: 99%

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Pre-operative Evaluation of Lateral Pelvic Lymph Node Metastasis in Lower Rectal Cancer: Comparison of Three Different Imaging Modalities

Amano

Fukuchi

Kumamoto

et al. 2020

J Anus Rectum Colon

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Objectives: The pre-operative diagnostic value of detecting lateral pelvic lymph node (LPLN) metastasis with magnetic resonance imaging, multidirectory computed tomography, and positron emission tomography/ computed tomography was investigated in lower rectal cancer patients. Methods: We retrospectively evaluated, using the three different modalities, the metastatic status of LPLNs in four regions, including both the internal iliac and the obturator, in 46 patients affected by lower rectal cancer patients who underwent LPLN dissection. The size inclusion criterion for LPLN metastasis was set at 6 mm in the short axis diameter. Histological examination was performed for determining the false positive and negative rate of LPLNs metastasis detection. Results: Among 184 LPLNs regions, 17 (9%) were positive for metastasis. The region-based sensitivity, specificity, and accuracy rate did not differ among the three tested diagnostic modalities. Moreover, a significant increase in these rates could not be observed when the modalities were combined. Of 184 regions, 8 (4.4%) were false negative, whereas 2 (1.1%) were false positive. The histological pattern of metastatic regions did not differ in 8 false negative LPLNs. Conclusions: Each modality had a similar detection power for LPLNs metastasis, with a cut-off value at 6 mm in the short axis diameter. However, the sensitivity of all the modalities was slightly low, along with the number of false negative LPLNs. Further reduction of the false negative rate with these modalities may be difficult because of an inherent limitation of current imaging technologies to accurately detect lymph node metastases.

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“…Although accurate presurgical diagnosis of LPN metastasis is difficult, LPN size (as measured using imaging modalities) has frequently been used to predict the presence of metastasis. In a study of patients who did not undergo neoadjuvant CRT, the sensitivity and specificity of LPN size as a predictor of metastasis were 68.6-87% and 79.7-81.0%, respectively [9,10]. In a study of patients who did receive neoadjuvant CRT, the sensitivity and specificity of postneoadjuvant CRT LPN size were reported to be 67.7 and 84.8%, respectively [11].…”

Section: Introductionmentioning

confidence: 99%

Correlations between the Recurrence Patterns and Sizes of Lateral Pelvic Lymph Nodes before and after Chemoradiotherapy in Patients with Lower Rectal Cancer

et al. 2018

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Objective: Factors that predict rectal cancer metastasis to the lungs remain undefined. We investigated whether the lateral pelvic lymph node (LPN) sizes before and after chemoradiotherapy (CRT) correlate with lung metastasis after surgery for lower rectal cancer. Methods: Two hundred and forty patients with lower rectal cancer who received preoperative CRT and curative surgery between 2003 and 2017 were examined. Computed tomography-measured LPN sizes before and after CRT were retrospectively determined by 1 colorectal surgeon who was blinded to the patients’ clinical and pathological outcomes. Results: The 5-year cumulative lung metastasis rates were 15.2%. The mean LPN sizes in patients who developed lung metastasis were larger than those in patients who did not (pre-CRT: 8.7 vs. 6.3 mm, p = 0.003; post-CRT: 6.8 vs. 4.5 mm, p = 0.001). The cumulative lung metastasis rate in patients with large LPNs was higher than in those with small LPNs both before and after CRT. On multivariate analysis, lung metastasis was independently correlated with the LPN size only after CRT (hazard ratio [HR]: 5.58), together with the ypT stage (HR: 2.96) and the tumor location (HR: 0.38). Conclusions: LPN size after CRT is strongly predictive of postoperative lung metastasis in patients with lower rectal cancer.

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Selection of Lymph Node–Positive Cases Based on Perirectal and Lateral Pelvic Lymph Nodes Using Magnetic Resonance Imaging: Study of the Japanese Society for Cancer of the Colon and Rectum

Cited by 74 publications

References 19 publications

Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

Pre-operative Evaluation of Lateral Pelvic Lymph Node Metastasis in Lower Rectal Cancer: Comparison of Three Different Imaging Modalities

Correlations between the Recurrence Patterns and Sizes of Lateral Pelvic Lymph Nodes before and after Chemoradiotherapy in Patients with Lower Rectal Cancer

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