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Kaur H, Gabriel H, Awiwi MO, Maheshwari E, Lopes Vendrami C, Konishi T, Taggart MW, Magnetta M, Kelahan LC, Lee S. Anatomic Basis of Rectal Cancer Staging: Clarifying Controversies and Misconceptions. Radiographics 2024; 44:e230203. [PMID: 38900679 DOI: 10.1148/rg.230203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Rectal MRI provides a detailed depiction of pelvic anatomy; specifically, the relationship of the tumor to key anatomic structures, including the mesorectal fascia, anterior peritoneal reflection, and sphincter complex. However, anatomic inconsistencies, pitfalls, and confusion exist, which can have a strong impact on interpretation and treatment. These areas of confusion include the definition of the rectum itself, specifically differentiation of the rectum from the anal canal and the sigmoid colon, and delineation of the high versus low rectum. Other areas of confusion include the relative locations of the mesorectal fascia and peritoneum and their significance in staging and treatment, the difference between the mesorectal fascia and circumferential resection margin, involvement of the sphincter complex, and evaluation of lateral pelvic lymph nodes. The impact of these anatomic inconsistencies and sources of confusion is significant, given the importance of MRI in depicting the anatomic relationship of the tumor to critical pelvic structures, to triage surgical resection and neoadjuvant chemoradiotherapy with the goal of minimizing local recurrence. Evolving treatment paradigms also place MRI central in management of rectal cancer. ©RSNA, 2024.
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Affiliation(s)
- Harmeet Kaur
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Helena Gabriel
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Muhammad O Awiwi
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Ekta Maheshwari
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Camila Lopes Vendrami
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Tsuyoshi Konishi
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Melissa W Taggart
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Michael Magnetta
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Linda C Kelahan
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
| | - Sonia Lee
- From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.); Department of Radiology, University of Texas Health Science Center, Houston, Tex (M.O.A.); Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (E.M.); Department of Radiology, Endeavor Health Medical Group, Evanston, Ill (M.M.); and Department of Radiological Sciences, University of California, Irvine, School of Medicine, Orange, Calif (S.L.)
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Ma Y, Ma D, Xu X, Li J, Guan Z. Progress of MRI in predicting the circumferential resection margin of rectal cancer: A narrative review. Asian J Surg 2024; 47:2122-2131. [PMID: 38331609 DOI: 10.1016/j.asjsur.2024.01.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/02/2024] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
Rectal cancer (RC) is the third most frequently diagnosed cancer worldwide, and the status of its circumferential resection margin (CRM) is of paramount significance for treatment strategies and prognosis. CRM involvement is defined as tumor touching or within 1 mm from the outermost part of tumor or outer border of the mesorectal or lymph node deposits to the resection margin. The incidence of involved CRM varied from 5.4 % to 36 %, which may associate with an in consistent definition of CRM, the quality of surgeries, and the different examination modalities. Although T and N status are essential factors in determining whether a patient should receive neoadjuvant therapy before surgery, CRM status is a powerful predictor of local and distant recurrence as well as survival rate. This review explores the significance of CRM, the various assessment methods, and the role of magnetic resonance imaging (MRI) and artificial intelligence-based MRI in predicting CRM status. MRI showed potential advantage in predicting CRM status with a high sensitivity and specificity compared to computed tomography (CT). We also discuss MRI advancements in RC imaging, including conventional MRI with body coil, high-resolution MRI with phased-array coil, and endorectal MRI. Along with a discussion of artificial intelligence-based MRI techniques to predict the CRM status of RCs before and after treatments.
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Affiliation(s)
- Yanqing Ma
- Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.
| | - Dongnan Ma
- Yangming College of Ningbo University, Ningbo, Zhejiang, 315010, China.
| | - Xiren Xu
- Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.
| | - Jie Li
- Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.
| | - Zheng Guan
- Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.
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Li QY, Yang D, Guan Z, Yan XY, Li XT, Sun RJ, Lu QY, Zhang XY, Sun YS. Extranodal Extension at Pretreatment MRI and the Prognostic Value for Patients with Rectal Cancer. Radiology 2024; 310:e232605. [PMID: 38530176 DOI: 10.1148/radiol.232605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background Detection of extranodal extension (ENE) at pathology is a poor prognostic indicator for rectal cancer, but whether ENE can be identified at pretreatment MRI is, to the knowledge of the authors, unknown. Purpose To evaluate the performance of pretreatment MRI in detecting ENE using a matched pathologic reference standard and to assess its prognostic value in patients with rectal cancer. Materials and Methods This single-center study included a prospective development data set consisting of participants with rectal adenocarcinoma who underwent pretreatment MRI and radical surgery (December 2021 to January 2023). MRI characteristics were identified by their association with ENE-positive nodes (χ2 test and multivariable logistic regression) and the performance of these MRI features was assessed (area under the receiver operating characteristic curve [AUC]). Interobserver agreement was assessed by Cohen κ coefficient. The prognostic value of ENE detected with MRI for predicting 3-year disease-free survival was assessed by Cox regression analysis in a retrospective independent validation cohort of patients with locally advanced rectal cancer (December 2019 to July 2020). Results The development data set included 147 participants (mean age, 62 years ± 11 [SD]; 87 male participants). The retrospective cohort included 110 patients (mean age, 60 years ± 9; 79 male participants). Presence of vessel interruption and fusion (both P < .001), heterogeneous internal structure, and the broken-ring and tail signs (odds ratio range, 4.10-23.20; P value range, <.001 to .002) were predictors of ENE at MRI, and together achieved an AUC of 0.91 (95% CI: 0.88, 0.93) in detecting ENE. Interobserver agreement was moderate for the presence of vessel interruption and fusion (κ = 0.46 for both) and substantial for others (κ = 0.61-0.67). The presence of ENE at pretreatment MRI was independently associated with worse 3-year disease-free survival (hazard ratio, 3.00; P = .02). Conclusion ENE can be detected at pretreatment MRI, and its presence was associated with worse prognosis for patients with rectal cancer. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Eberhardt in this issue.
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Affiliation(s)
- Qing-Yang Li
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Ding Yang
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Zhen Guan
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Xin-Yue Yan
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Xiao-Ting Li
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Rui-Jia Sun
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Qiao-Yuan Lu
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Xiao-Yan Zhang
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
| | - Ying-Shi Sun
- From the Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, Beijing 100142, China
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Paroder V, Fraum TJ, Nougaret S, Petkovska I, Rauch GM, Kaur H. Key clinical trials in rectal cancer shaping the current treatment paradigms: reference guide for radiologists. Abdom Radiol (NY) 2023; 48:2825-2835. [PMID: 37221342 DOI: 10.1007/s00261-023-03931-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/25/2023]
Abstract
Total neoadjuvant therapy (TNT), which includes chemotherapy and radiation prior to surgical resection, has been recently accepted as the new standard of care for patients with locally advanced low and mid rectal cancers. Multiple clinical trials have evaluated this approach in the last several decades and demonstrated improvement in, local control and reduced risk of recurrence. In addition, in the course of these investigations, it has been shown that between a third and a half of patients experience a clinical complete response (cCR) after being treated with the TNT approach, leading to the development of new organ preservation protocol, now known as watch-and-wait (W&W). On this protocol, cCR patients are not referred for surgery after total neoadjuvant treatment. Instead, they remain on close surveillance and, thus, avoid potential complications associated with surgical resection. Multiple clinical trials are ongoing, investigating the long-term outcomes of these new approaches and the development of less toxic and more effective TNT regimens for LARC. Improvements in technology and rectal MRI protocols position radiologists as vital members of multidisciplinary rectal cancer management teams. Rectal MRI has become a critical tool for rectal cancer initial staging, treatment response assessment, and surveillance on W&W protocols. In this review, we summarize the findings of the pivotal clinical trials that contributed to establishing the current treatment paradigms in locally advanced rectal cancer (LARC) management, with the intention of helping radiologists play more effective roles in their multidisciplinary teams.
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Affiliation(s)
- Viktoriya Paroder
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Tyler J Fraum
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Stephanie Nougaret
- Department of Radiology, Montpellier Cancer Institute (ICM), Montpellier, France
| | - Iva Petkovska
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gaiane M Rauch
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Harmeet Kaur
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Wetzel A, Viswanath S, Gorgun E, Ozgur I, Allende D, Liska D, Purysko AS. Staging and Restaging of Rectal Cancer With MRI: A Pictorial Review. Semin Ultrasound CT MR 2022; 43:441-454. [DOI: 10.1053/j.sult.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zhao Z, Zhou Y, Jiang M, Dang L. Application Value of MRI Combined with MSCT in Diagnosis and Staging of Colon Carcinoma. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2593844. [PMID: 35651927 PMCID: PMC9150994 DOI: 10.1155/2022/2593844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 12/04/2022]
Abstract
Objective To clarify the application value of magnetic resonance imaging (MRI) combined with multislice spiral computed tomography (MSCT) in the diagnosis and staging of colon carcinoma (CC). Methods A total of 103 patients with histopathologically diagnosed CC were enrolled. Patient clinical and imaging data were collected, and MRI and MSCT images were analyzed to assess the accuracy of MRI, MSCT, and their combination in diagnosing tumor (T) staging of CC. Results Among the 103 cases of histopathologically diagnosed CC, 26 cases (25.24) were in stage T1-2, 72 cases (69.90) were in stage T3, and 5 cases (4.85) were in stage T4. The accuracy of MRI in diagnosing stage T1-2, T3, and T4 was 80.77%, 88.89%, and 60.00%, respectively, with an average of 76.55%. The accuracy rates of MSCT in diagnosing T1-2, T3, and T4 stages were 73.08%, 90.27%, and 60.00%, respectively, with an average of 74.45%. The accuracy rates of MRI+MSCT in diagnosing T1-2, T3, and T4 were 88.46%, 95.83%, and 80.00%, respectively, with an average of 88.10%. Conclusions Compared with single use of MRI or MSCT, MRI+MSCT provides accurate imaging data with higher accuracy, which is more helpful for the T-staging evaluation of CC.
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Affiliation(s)
- Zhiwei Zhao
- Medical Imaging Center, The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, 830011 Xinjiang, China
| | - Yong Zhou
- Medical Imaging Center, The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, 830011 Xinjiang, China
| | - Meng Jiang
- Department of Gastroenterology, People's Hospital of Tongchuan, Tongchuan, 727000 Shaanxi, China
| | - Ling Dang
- Department of Gastroenterology, People's Hospital of Tongchuan, Tongchuan, 727000 Shaanxi, China
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Zhang L, Wang F. Evaluation of Nursing Effects of Pelvic Floor Muscle Rehabilitation Exercise on Gastrointestinal Tract Rectal Cancer Patients Receiving Anus-preserving Operation by Intelligent Algorithm-based Magnetic Resonance Imaging. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:1613632. [PMID: 35655733 PMCID: PMC9135567 DOI: 10.1155/2022/1613632] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
Based on magnetic resonance imaging (MRI) technology under artificial intelligence algorithm, the postoperative nursing effects of pelvic floor muscle rehabilitation exercise on gastrointestinal tract rectal cancer (RC) patients were investigated. A total of 88 patients receiving RC anus-preserving surgery in hospital were selected. The included patients were divided randomly into the experimental group (44 cases) and the control group (44 cases). Patients in the control group engaged in Kegel motion, while patients in the experimental group underwent self-designed comprehensive pelvic floor training. Anorectum function rating scale and quality of life questionnaire for colorectal cancer (EORTC QLQ-CR29) were utilized to compare and analyze anus functions and living quality of patients in the two groups. Besides, all patients in two groups received MRI examinations, and images were processed by a convolutional neural network (CNN) algorithm. The results showed that in MRI images, there were significant signal differences between lesion tissues and normal tissues. After being processed by an artificial intelligence algorithm, the definition of MRI images was remarkably enhanced with clearer lesion edges. The quality of images was also significantly improved. Besides, the comparison of anus functions of patients in two groups showed that the differences demonstrated statistical meaning after the intervention (P < 0.05). In conclusion, artificial intelligence algorithm-based MRI and comprehensive pelvic floor muscle exercise showed significant application prospects and values in the recovery of patients' intestinal functions after RC anus-preserving surgery.
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Affiliation(s)
- Lijuan Zhang
- Department of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, Shanxi, China
| | - Feng Wang
- Clinical Laboratory, Shanxi Children's Hospital, Taiyuan 030013, Shanxi, China
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Nougaret S, Rousset P, Gormly K, Lucidarme O, Brunelle S, Milot L, Salut C, Pilleul F, Arrivé L, Hordonneau C, Baudin G, Soyer P, Brun V, Laurent V, Savoye-Collet C, Petkovska I, Gerard JP, Rullier E, Cotte E, Rouanet P, Beets-Tan RGH, Frulio N, Hoeffel C. Structured and shared MRI staging lexicon and report of rectal cancer: A consensus proposal by the French Radiology Group (GRERCAR) and Surgical Group (GRECCAR) for rectal cancer. Diagn Interv Imaging 2022; 103:127-141. [PMID: 34794932 DOI: 10.1016/j.diii.2021.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE To develop French guidelines by experts to standardize data acquisition, image interpretation, and reporting in rectal cancer staging with magnetic resonance imaging (MRI). MATERIALS AND METHODS Evidence-based data and opinions of experts of GRERCAR (Groupe de REcherche en Radiologie sur le CAncer du Rectum [i.e., Rectal Cancer Imaging Research Group]) and GRECCAR (Groupe de REcherche en Chirurgie sur le CAncer du Rectum [i.e., Rectal Cancer Surgery Research Group]) were combined using the RAND-UCLA Appropriateness Method to attain consensus guidelines. Experts scoring of reporting template and protocol for data acquisition were collected; responses were analyzed and classified as "Recommended" versus "Not recommended" (when ≥ 80% consensus among experts) or uncertain (when < 80% consensus among experts). RESULTS Consensus regarding patient preparation, MRI sequences, staging and reporting was attained using the RAND-UCLA Appropriateness Method. A consensus was reached for each reporting template item among the experts. Tailored MRI protocol and standardized report were proposed. CONCLUSION These consensus recommendations should be used as a guide for rectal cancer staging with MRI.
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Affiliation(s)
- Stephanie Nougaret
- Department of Radiology, Institut Régional du Cancer de Montpellier, Montpellier Cancer Research Institute, INSERM U1194, University of Montpellier, 34295, Montpellier, France.
| | - Pascal Rousset
- Department of Radiology, Lyon 1 Claude-Bernard University, 69495 Pierre-Benite, France
| | - Kirsten Gormly
- Dr Jones & Partners Medical Imaging, Kurralta Park, 5037, Australia; University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia
| | - Oliver Lucidarme
- Department of Radiology, Pitié-Salpêtrière Hospital, Sorbonne Université, 75013 Paris, France; LIB, INSERM, CNRS, UMR7371-U1146, 75013 Paris, France
| | - Serge Brunelle
- Department of Radiology, Institut Paoli-Calmettes, 13009 Marseille, France
| | - Laurent Milot
- Radiology Department, Hospices Civils de Lyon, Lyon Sud University Hospital, 69495 Pierre Bénite, France; Lyon 1 Claude Bernard University, 69100 Villeurbanne, France
| | - Cécile Salut
- Department of Radiology, CHU de Bordeaux, Université de Bordeaux, 33000 Bordeaux, France
| | - Franck Pilleul
- Department of Radiology, Centre Léon Bérard, Lyon, France Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621, Lyon, France
| | - Lionel Arrivé
- Department of Radiology, Hopital St Antoine, Paris, France
| | - Constance Hordonneau
- Department of Radiology, CHU Estaing, Université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - Guillaume Baudin
- Department of Radiology, Centre Antoine Lacassagne, 06100 Nice, France
| | - Philippe Soyer
- Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France; Université de Paris, 75006 Paris, France
| | - Vanessa Brun
- Department of Radiology, CHU Hôpital Pontchaillou, 35000 Rennes Cedex, France
| | - Valérie Laurent
- Department of Radiology, Brabois-Nancy University Hospital, Université de Lorraine, 54500 Vandoeuvre-lès-Nancy, France
| | | | - Iva Petkovska
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Jean Pierre Gerard
- Department of Radiotherapy, Centre Antoine Lacassagne, 06100 Nice, France
| | - Eric Rullier
- Department of Digestive Surgery, Hôpital Haut-Lévèque, Université de Bordeaux, 33600 Pessac, France
| | - Eddy Cotte
- Department of Digestive Surgery, Hospices Civils de Lyon, Lyon Sud University Hospital, 69310 Pierre Bénite, France; Lyon 1 Claude Bernard University, 69100 Villeurbanne, France
| | - Philippe Rouanet
- Department of surgery, Institut Régional du Cancer de Montpellier, Montpellier Cancer Research Institute, INSERM U1194, University of Montpellier, 34295, Montpellier, France
| | - Regina G H Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, 1066 CX, Amsterdam, the Netherlands
| | - Nora Frulio
- Department of Radiology, CHU de Bordeaux, Université de Bordeaux, 33000 Bordeaux, France
| | - Christine Hoeffel
- Department of Radiology, Hôpital Robert Debré & CRESTIC, URCA, 51092 Reims, France
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