Value of MRI and diffusion-weighted MRI for the diagnosis of locally recurrent rectal cancerReport as inadecuate




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European Radiology

, Volume 21, Issue 6, pp 1250–1258

First Online: 16 January 2011Received: 14 October 2010Revised: 22 November 2010Accepted: 25 November 2010

Abstract

ObjectivesTo 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.

MethodsForty-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.

Results19-42 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 κ0.69 for standard MRI, κ0.82 for standard MRI+DWI and κ0.84 for the fusion images.

ConclusionsMRI 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.

KeywordsMRI Diffusion magnetic resonance imaging Rectal neoplasms Local neoplasm recurrence Diagnosis  Download fulltext PDF



Author: Doenja M. J. Lambregts - Vincent C. Cappendijk - Monique Maas - Geerard L. Beets - Regina G. H. Beets-Tan

Source: https://link.springer.com/







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