open access

Vol 22, No 4 (2017)
Original research articles
Published online: 2017-07-01
Submitted: 2016-11-14
Get Citation

Neoadjuvant chemoradiotherapy of the rectal carcinoma – The correlation between the findings on the restaging multiparametric 3T MRI scanning and the surgical findings

Radovan Vojtíšek, Eva Korčáková, Jan Mařan, Ondřej Šorejs, Jindřich Fínek
DOI: 10.1016/j.rpor.2017.02.004
·
Rep Pract Oncol Radiother 2017;22(4):265-276.

open access

Vol 22, No 4 (2017)
Original research articles
Published online: 2017-07-01
Submitted: 2016-11-14

Abstract

Aim

To figure out how to correlate the findings on functional MRI and carried out after neoadjuvant CRT of rectal carcinoma with final histology after surgery.

Background

Neoadjuvant CRT is the standard treatment of locally advanced rectal carcinoma. Its use leads to the downstaging of the disease and in 15–42% of patients even to the detection of pCR after TME. The use of functional MRI improves the sensitivity and specificity of pCR detection up to 52–64% and 89–98%, respectively.

Materials and methods

Between January 2013 and June 2016, 67 patients suffering from histologically proven locally advanced rectal cancer underwent neoadjuvant RT or CRT. We selected for further investigation only patients (33 patients) who underwent pelvic staging and restaging using multiparametric imaging on 3T MRI scanner. We compared the findings on functional MRI after neoadjuvant CRT with final histology after surgery.

Results

In 15 patients pathologic staging of primary tumor differed from expected staging assessed according to preoperative MRI. In 5 patients pathologic complete remission was achieved. In none of these 5 patients pCR was predicted using preoperative MRI. Sensitivity and specificity of MRI in predicting pCR were 0% and 96%. Accuracy of MRI in predicting pT and pN was 79% and 74%.

Conclusions

We have verified that the use of neoadjuvant CRT in the treatment of locally advanced rectal carcinoma leads to a possible achievement of pCR. But in our group of patients this was not predictable nor was it with the use of multiparametric 3T MRI.

Abstract

Aim

To figure out how to correlate the findings on functional MRI and carried out after neoadjuvant CRT of rectal carcinoma with final histology after surgery.

Background

Neoadjuvant CRT is the standard treatment of locally advanced rectal carcinoma. Its use leads to the downstaging of the disease and in 15–42% of patients even to the detection of pCR after TME. The use of functional MRI improves the sensitivity and specificity of pCR detection up to 52–64% and 89–98%, respectively.

Materials and methods

Between January 2013 and June 2016, 67 patients suffering from histologically proven locally advanced rectal cancer underwent neoadjuvant RT or CRT. We selected for further investigation only patients (33 patients) who underwent pelvic staging and restaging using multiparametric imaging on 3T MRI scanner. We compared the findings on functional MRI after neoadjuvant CRT with final histology after surgery.

Results

In 15 patients pathologic staging of primary tumor differed from expected staging assessed according to preoperative MRI. In 5 patients pathologic complete remission was achieved. In none of these 5 patients pCR was predicted using preoperative MRI. Sensitivity and specificity of MRI in predicting pCR were 0% and 96%. Accuracy of MRI in predicting pT and pN was 79% and 74%.

Conclusions

We have verified that the use of neoadjuvant CRT in the treatment of locally advanced rectal carcinoma leads to a possible achievement of pCR. But in our group of patients this was not predictable nor was it with the use of multiparametric 3T MRI.

Get Citation

Keywords

Rectal carcinoma; Neoadjuvant chemoradiotherapy; 3T MRI scanning; Restaging

About this article
Title

Neoadjuvant chemoradiotherapy of the rectal carcinoma – The correlation between the findings on the restaging multiparametric 3T MRI scanning and the surgical findings

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 22, No 4 (2017)

Pages

265-276

Published online

2017-07-01

DOI

10.1016/j.rpor.2017.02.004

Bibliographic record

Rep Pract Oncol Radiother 2017;22(4):265-276.

Keywords

Rectal carcinoma
Neoadjuvant chemoradiotherapy
3T MRI scanning
Restaging

Authors

Radovan Vojtíšek
Eva Korčáková
Jan Mařan
Ondřej Šorejs
Jindřich Fínek

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