Accuracy of magnetic resonance imaging in the pre-operative staging of rectal adenocarcinoma: Experience from a regional Australian cancer center

2012 ◽  
Vol 9 (4) ◽  
pp. 318-323 ◽  
Author(s):  
Rohen White ◽  
Kim Ann Ung ◽  
Maitham Mathlum
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rectal Adenocarcinoma ◽  
Cancer Center ◽  
Resonance Imaging ◽  
Operative Staging

Evaluation of Extramural Venous Invasion by Diffusion-Weighted Magnetic Resonance Imaging and Computed Tomography in Rectal Adenocarcinoma

2019 ◽  
Vol 70 (4) ◽  
pp. 457-465 ◽  
Author(s):  
Aysegul Gursoy Coruh ◽  
Elif Peker ◽  
Atilla Elhan ◽  
Ilhan Erden ◽  
Ayse Erden
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Roc Analysis ◽  
Rectal Adenocarcinoma ◽  
Venous Invasion ◽  
Distant Metastases ◽  
Resonance Imaging ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging

Purpose The aim of this study is to evaluate the diagnostic contribution of diffusion-weighted magnetic resonance imaging (MRI) and computed tomography (CT) to distinguish extramural venous invasion (EMVI) in rectal adenocarcinoma. Materials and Methods Fifty-eight patients who had been diagnosed with rectal adenocarcinoma (30 patients with EMVI and 28 patients without EMVI) were enrolled in the study. Apparent diffusion coefficient (ADC) values of the tumour and the EMVI (+) vein, the lengths of the tumours were measured on MRI. The diameters of the superior rectal vein (SRV)-inferior mesenteric vein (IMV) and distant metastatic spread were evaluated on CT. The ability of these findings to detect EMVI was assessed using receiver operating characteristic (ROC) analysis. Pathology was accepted as the reference test for EMVI. Results Mean diameters of the SRV (4.9 ± 0.9 mm vs 3.7 ± 0.8 mm) and IMV (6.9 ± 0.8 mm vs 5.4 ± 0.9 mm) were significantly larger ( P < .001) and tumour ADC values were significantly lower (0.926 ± 0.281 × 10−3 mm2/s vs 1.026 ± 0.246 × 10−3 mm2/s; P = .032) in EMVI (+) patients. Diameters of 3.95 mm for the SRV (area under the curve [AUC] ± standard error [SE]: 0.851 ± 0.051, P < .001, sensitivity: 93.3%, specificity: 67.9%) and 5.95 mm for the IMV (AUC ± SE: 0.893 ± 0.040, P < .001, sensitivity: 93.3%, specificity: 71.4%) and an ADC value of 0.929 × 10−3 mm2/s (AUC ± SE: 0.664 ± 0.072, P = .032 sensitivity: 76.7%, specificity: 57.1%) were found to be cutoff values, determined by ROC analysis, for detection of EMVI. Distant metastases were significantly more prevalent in EMVI (+) patients ( P < .001). Conclusion The measurement of ADC values and SRV-IMV diameters seems to have contribution for diagnosis of EMVI in rectal adenocarcinoma. EMVI (+) patients appear to have higher risks of distant metastases at diagnosis.

scholarly journals Evaluation of the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer, according to the American College of Radiology criteria

2017 ◽  
Vol 50 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Camila Silva Boaventura ◽  
Daniel Padilha Rodrigues ◽  
Olimpio Antonio Cornehl Silva ◽  
Fabrício Henrique Beltrani ◽  
Rayssa Araruna Bezerra de Melo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pelvic Pain ◽  
Cancer Center ◽  
Resonance Imaging ◽  
Female Pelvis ◽  
Referral Center ◽  
Acr Criteria ◽  
Pelvic Malignancies ◽  
Gynecologic Neoplasms

Abstract Objective: To evaluate the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer. Materials and Methods: This was a retrospective, single-center study, conducted by reviewing medical records and imaging reports. We included 1060 female patients who underwent magnetic resonance imaging of the pelvis at a cancer center between January 2013 and June 2014. The indications for performing the examination were classified according to the American College of Radiology (ACR) criteria. Results: The mean age of the patients was 52.6 ± 14.8 years, and 49.8% were perimenopausal or postmenopausal. The majority (63.9%) had a history of cancer, which was gynecologic in 29.5% and nongynecologic in 34.4%. Of the patients evaluated, 44.0% had clinical complaints, the most common being pelvic pain (in 11.5%) and bleeding (in 9.8%), and 34.7% of patients had previously had abnormal findings on ultrasound. Most (76.7%) of the patients met the criteria for undergoing magnetic resonance imaging, according to the ACR guidelines. The main indications were evaluation of tumor recurrence after surgical resection (in 25.9%); detection and staging of gynecologic neoplasms (in 23.3%); and evaluation of pelvic pain or of a mass (in 17.1%). Conclusion: In the majority of the cases evaluated, magnetic resonance imaging was clearly indicated according to the ACR criteria. The main indication was local recurrence after surgical treatment of pelvic malignancies, which is consistent with the routine protocols at cancer centers.

scholarly journals Impact of neoadjuvant therapy in downstaging of lower rectal adenocarcinoma and the role of pelvic magnetic resonance in staging

2016 ◽  
Vol 43 (2) ◽  
pp. 102-109 ◽  
Author(s):  
Karina Dagre Magri ◽  
Fang Chia Bin ◽  
Fernanda Bellotti Formiga ◽  
Thiago da Silveira Manzione ◽  
Caroline Merci Caliari de Neves Gomes ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neoadjuvant Therapy ◽  
Rectal Adenocarcinoma ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Pelvic Magnetic Resonance Imaging ◽  
Group 2 ◽  
Locoregional Staging ◽  
Group 1

ABSTRACT Objective: to evaluate the effect of neoadjuvant therapy on the stage (TNM) of patients with rectal adenocarcinoma and validate the use of MRI as a method of determining locoregional stage. Methods: we conducted a retrospective study of 157 patients with lower rectum adenocarcinoma, whom we divided into two groups: Group 1, 81 patients (52%) who had undergone surgical treatment initially, with the purpose to analyze the accuracy of locoregional staging by pelvic magnetic resonance imaging throug the comparison of radiological findings with pathological ones; Group 2, 76 patients (48%), who had been submitted to neoadjuvant therapy (chemotherapy and radiation) prior to definitive surgical treatment, so as to evaluate its effects on the stage by comparing clinical and radiological findings with pathology. Results: In group 1, the accuracy of determining tumor depth (T) and lymph node involvement (N) was 91.4% and 82.7%, respectively. In group 2, neoadjuvant therapy decreased the T stage, N stage and TNM stage in 51.3%, 21% and 48.4% of cases, respectively. Conclusion: neoadjuvant therapy in patients with rectal adenocarcinoma is effective in decreasing disease stage, and pelvic magnetic resonance imaging is effective for locoregional staging.

scholarly journals Prostate Magnetic Resonance Imaging Analyses, Clinical Parameters, and Preoperative Nomograms in the Prediction of Extraprostatic Extension

2021 ◽  
Vol 11 (4) ◽  
pp. 763-775
Author(s):  
Natalia Majchrzak ◽  
Piotr Cieśliński ◽  
Maciej Głyda ◽  
Katarzyna Karmelita-Katulska
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Specific Antigen ◽  
Area Under The Curve ◽  
Specific Site ◽  
Cancer Center ◽  
Clinical Parameters ◽  
Resonance Imaging ◽  
Cognitive Fusion ◽  
Extraprostatic Extension

Introduction: Proper planning of laparoscopic radical prostatectomy (RP) in patients with prostate cancer (PCa) is crucial to achieving good oncological results with the possibility of preserving potency and continence. Aim: The aim of this study was to identify the radiological and clinical parameters that can predict the risk of extraprostatic extension (EPE) for a specific site of the prostate. Predictive models and multiparametric magnetic resonance imaging (mpMRI) data from patients qualified for RP were compared. Material and methods: The study included 61 patients who underwent laparoscopic RP. mpMRI preceded transrectal systematic and cognitive fusion biopsy. Martini, Memorial Sloan-Kettering Cancer Center (MSKCC), and Partin Tables nomograms were used to assess the risk of EPE. The area under the curve (AUC) was calculated for the models and compared. Univariate and multivariate logistic regression analyses were used to determine the combination of variables that best predicted EPE risk based on final histopathology. Results: The combination of mpMRI indicating or suspecting EPE (odds ratio (OR) = 7.49 (2.31–24.27), p < 0.001) and PSA ≥ 20 ng/mL (OR = 12.06 (1.1–132.15), p = 0.04) best predicted the risk of EPE for a specific side of the prostate. For the prediction of ipsilateral EPE risk, the AUC for Martini’s nomogram vs. mpMRI was 0.73 (p < 0.001) vs. 0.63 (p = 0.005), respectively (p = 0.131). The assessment of a non-specific site of EPE by MSKCC vs. Partin Tables showed AUC values of 0.71 (p = 0.007) vs. 0.63 (p = 0.074), respectively (p = 0.211). Conclusions: The combined use of mpMRI, the results of the systematic and targeted biopsy, and prostate-specific antigen baseline can effectively predict ipsilateral EPE (pT3 stage).

Evaluation of MRI/TRUS fusion targeted biopsy versus 12-Core standard biopsy with pre-biopsy 1.5 Tesla multi-parametric MRI for diagnosis of prostate cancer in a community cancer center.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 139-139
Author(s):  
Mark Gregory Bandyk
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Prospective Trial ◽  
Cancer Center ◽  
Low Grade ◽  
Resonance Imaging ◽  
New Paradigm ◽  
Fusion Biopsy ◽  
Biopsy Technique

139 Background: Academic centers report the magnetic resonance imaging (MRI)/ transrectal ultrasound (TRUS) fusion biopsy increases detection of high−risk and high Gleason score (GS) prostate cancer (CaP) as compared to standard 12−core biopsy among men for suspected CaP. This prospective trial evaluated the utility and benefits of performing MRI/TRUS fusion biopsy in a community cancer center. Methods: Men suspected of CaP underwent prostate multi−parametric magnetic resonance imaging (mpMRI) using a 1.5 tesla GE 450W GEMS magnet with a 32 channel phased anterior array coil to identify suspicious regions for prostate cancer. Regions were graded with Prostate Imaging Reporting and Data System (PI−RADS V2.0) by a single radiologist (5 years of experience). Men underwent concurrent MRI/TRUS fusion targeted and 12−core standard biopsies using an image guided fusion system. This prospective trial evaluated 79 men for number of positive biopsies by GS, biopsy technique and cohort (biopsy naïve, prior negative biopsy and CaP under surveillance). McNemar test was used for statistical analysis. Results: Study group included 79 men (mean age 66 years) with mean PSA 8.25 ng/mL. Cancer detection rate (CDR) and GS for the entire cohort by biopsy technique were determined. Overall, target biopsy (TB) diagnosed more GS ≥ 7 versus the 12−core standard biopsy (SB) (26 vs 18) and less GS6 (13 vs 21) (p = 0.057). Exact agreement was demonstrated in 66% of cases between TB and SB for GS ≥ 7, GS6 and no cancer. SB found cancers in 11 men missed by the TB, but 73% of these cancers were low grade GS6. TB of higher PI−RADS category lesions found more and higher grade cancers: 73% PI−RAD 5, GS ≥ 7; 80% PI−RAD 4, GS > 6; and 73% PI−RAD 3 were benign. In the biopsy naïve group (32 men), TB detected more GS ≥ 7 than SB (19 vs 13) (p = 0.11). Conclusions: Utilizing a mpMRI with a 1.5 tesla magnet and no endorectal coil, these encouraging preliminary results suggest MRI/TRUS fusion biopsy can be validated in the community for CaP detection. Results support a new paradigm in CaP detection utilizing pre−biopsy mpMRI and targeting higher PI−RADS lesions possibly eliminating SB.

Sign in / Sign up

Export Citation Format

Share Document