MRT beim präoperativen Staging von Rektumkarzinomen View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-10-28

AUTHORS

M. Willis, J. Streit, S. Willis, M. Rebel, G. Layer

ABSTRACT

Background and objectiveMagnetic resonance imaging (MRI) diagnostics are currently the most important examination for indications of neoadjuvant therapy in rectal cancer. This study was intended to test the applicability of formerly recommended diagnostic criteria for preoperative MRI evaluation in the clinical routine.MethodsData from 274 patients with histologically confirmed rectal cancer who underwent surgery at the City Hospital Ludwigshafen between 1 November 2009 and 31 December 2016 were retrospectively analyzed. A total of 153 patients received neoadjuvant therapy and were excluded from the study. The remaining patients underwent primary surgery and, if necessary, adjuvant follow-up treatment. The included MRI data (n = 99) were evaluated separately by 3 readers with different levels of experience and compared with the postoperative histological findings.ResultsThe T‑stage was correctly predicted in 60.3%. Overstaging and understaging occurred at approximately the same frequency. The preoperative assessment of lymph node involvement was correct in an average of 61.2% of the cases. The involvement of the resection margins (negative at a tumor distance >1 mm from the mesorectal fascia) was correctly determined in 80.4% of cases. Resection margins evaluated as negative in MRI were also histologically tumor-free with a probability of 99.1%.DiscussionPreoperative MRI diagnostics are less powerful in the clinical routine than described in the literature. The observations in this study show that the indications for neoadjuvant therapy should be made less dependent on the UICC stage than on the degree of infiltration in relation to the circumferential resection margin (CRM). It was also shown that the general radiological experience of the reader is less decisive than a detailed training in the topic and that the field strength does not have a significant influence on the value of the diagnostics. More... »

PAGES

437-443

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00053-019-00411-1

DOI

http://dx.doi.org/10.1007/s00053-019-00411-1

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https://app.dimensions.ai/details/publication/pub.1122146163


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