Skip to main content
Top
Published in: Abdominal Radiology 5/2019

01-05-2019 | Hollow Organ GI

Diagnostic performance of MRI- versus MDCT-categorized T3cd/T4 for identifying high-risk stage II or stage III colon cancers: a pilot study

Authors: Soo Yeun Park, Seung Hyun Cho, Min A. Lee, Ghilsuk Yoon, Hye Jin Kim, Jun Seok Park, Won Hwa Kim, So Mi Lee, Kyung-Min Shin, Hye Jung Kim, Gab Chul Kim, See Hyung Kim, Gyu-Seog Choi

Published in: Abdominal Radiology | Issue 5/2019

Login to get access

Abstract

Purpose

The aim of this study was to determine the diagnostic performance of magnetic resonance imaging (MRI)-categorized T3cd/T4 tumors for identifying high-risk stage II or stage III cancer in patients with curatively resectable colon cancer in comparison to that of multidetector computed tomography (MDCT).

Materials and Methods

Thirty-eight patients with histopathologically indicated adenocarcinomas prospectively underwent MRI of the colon. Two radiologists independently and retrospectively assessed for T-category, including T3 substage (≤ T3ab vs. ≥ T3cd). The diagnostic accuracies and interreader agreements between assessments using each modality were compared using a pairwise comparison of receiver-operating characteristic curves and a weighted κ statistic, respectively.

Results

Twenty-nine patients (76.3%) were histopathologically diagnosed with high-risk stage II or stage III colon cancer. The false-positive rate with MRI was lower than that with MDCT (0% vs. 7.9% for reader 1, 2.6% vs. 10.6% for reader 2). The diagnostic performance of MRI was better than that of MDCT across both readers (AUC: 0.707 vs. 0.506 [P = 0.032] for reader 1, 0.651 vs. 0.485 [P = 0.055] for reader 2). Moreover, MRI interreader agreement for the assessment of T3cd/T4 was significantly better than that of MDCT (κ = 0.821 vs. 0.391 [P = 0.017]).

Conclusion

The diagnostic performance of MR imaging of the colon may be better than that of MDCT for identifying high-risk stage II or stage III cases. Particularly, colon MRI reduced the false-positive rate and improved the interreader agreement, although further studies with a larger sample size are required.
Appendix
Available only for authorised users
Literature
1.
go back to reference Andre T, Boni C, Navarro M, et al. (2009) Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 27:3109–3116CrossRefPubMed Andre T, Boni C, Navarro M, et al. (2009) Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 27:3109–3116CrossRefPubMed
2.
go back to reference Andre T, Boni C, Mounedji-Boudiaf L, et al. (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351CrossRefPubMed Andre T, Boni C, Mounedji-Boudiaf L, et al. (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351CrossRefPubMed
3.
go back to reference Labianca R, Nordlinger B, Beretta GD, et al. (2010) Primary colon cancer: ESMO Clinical Practice Guidelines for diagnosis, adjuvant treatment and follow-up. Ann Oncol 21(Suppl 5):v70–v77CrossRefPubMed Labianca R, Nordlinger B, Beretta GD, et al. (2010) Primary colon cancer: ESMO Clinical Practice Guidelines for diagnosis, adjuvant treatment and follow-up. Ann Oncol 21(Suppl 5):v70–v77CrossRefPubMed
4.
go back to reference Kuebler JP, Wieand HS, O’Connell MJ, et al. (2007) Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol 25:2198–2204CrossRefPubMed Kuebler JP, Wieand HS, O’Connell MJ, et al. (2007) Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol 25:2198–2204CrossRefPubMed
5.
go back to reference Van Cutsem E, Kohne CH, Hitre E, et al. (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417CrossRefPubMed Van Cutsem E, Kohne CH, Hitre E, et al. (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417CrossRefPubMed
6.
go back to reference Medical Research Council Oesophageal Cancer Working Group (2002) Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet 359:1727–1733CrossRef Medical Research Council Oesophageal Cancer Working Group (2002) Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet 359:1727–1733CrossRef
7.
go back to reference Cunningham D, Allum WH, Stenning SP, et al. (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20CrossRefPubMed Cunningham D, Allum WH, Stenning SP, et al. (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20CrossRefPubMed
8.
go back to reference Sebag-Montefiore D, Stephens RJ, Steele R, et al. (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373:811–820CrossRefPubMedPubMedCentral Sebag-Montefiore D, Stephens RJ, Steele R, et al. (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373:811–820CrossRefPubMedPubMedCentral
9.
go back to reference Ludmir EB, Palta M, Willett CG, Czito BG (2017) Total neoadjuvant therapy for rectal cancer: An emerging option. Cancer 123:1497–1506CrossRefPubMed Ludmir EB, Palta M, Willett CG, Czito BG (2017) Total neoadjuvant therapy for rectal cancer: An emerging option. Cancer 123:1497–1506CrossRefPubMed
10.
go back to reference Foxtrot Collaborative Group (2012) Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial. Lancet Oncol 13:1152–1160CrossRefPubMedPubMedCentral Foxtrot Collaborative Group (2012) Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial. Lancet Oncol 13:1152–1160CrossRefPubMedPubMedCentral
11.
go back to reference Kotake K, Koyama Y, Shida S, et al. (2002) Neo-adjuvant chemotherapy with carmofur for colorectal cancer–a multi-institutional randomized controlled study. Gan To Kagaku Ryoho 29:1917–1924PubMed Kotake K, Koyama Y, Shida S, et al. (2002) Neo-adjuvant chemotherapy with carmofur for colorectal cancer–a multi-institutional randomized controlled study. Gan To Kagaku Ryoho 29:1917–1924PubMed
12.
go back to reference Colorectal Cancer Chemotherapy Study Group of Japan - The 2nd T (2003) Results of a randomized trial with or without 5-FU-based preoperative chemotherapy followed by postoperative chemotherapy in resected colon and rectal carcinoma. Jpn J Clin Oncol 33:288–296CrossRef Colorectal Cancer Chemotherapy Study Group of Japan - The 2nd T (2003) Results of a randomized trial with or without 5-FU-based preoperative chemotherapy followed by postoperative chemotherapy in resected colon and rectal carcinoma. Jpn J Clin Oncol 33:288–296CrossRef
13.
go back to reference Xu J, Zhong Y, Weixin N, et al. (2007) Preoperative hepatic and regional arterial chemotherapy in the prevention of liver metastasis after colorectal cancer surgery. Ann Surg 245:583–590CrossRefPubMedPubMedCentral Xu J, Zhong Y, Weixin N, et al. (2007) Preoperative hepatic and regional arterial chemotherapy in the prevention of liver metastasis after colorectal cancer surgery. Ann Surg 245:583–590CrossRefPubMedPubMedCentral
14.
go back to reference Zhong YS, Lu SX, Xu JM (2008) Tumor proliferation and apoptosis after preoperative hepatic and regional arterial infusion chemotherapy in prevention of liver metastasis after colorectal cancer surgery. Zhonghua Wai Ke Za Zhi 46:1229–1233PubMed Zhong YS, Lu SX, Xu JM (2008) Tumor proliferation and apoptosis after preoperative hepatic and regional arterial infusion chemotherapy in prevention of liver metastasis after colorectal cancer surgery. Zhonghua Wai Ke Za Zhi 46:1229–1233PubMed
15.
go back to reference Okabayashi K, Hasegawa H, Watanabe M, et al. (2012) Usefulness of the preoperative administration of tegafur suppositories as alternative adjuvant chemotherapy for patients with resectable stage II or III colorectal cancer: a KODK4 multicenter randomized control trial. Oncology 83:16–23CrossRefPubMed Okabayashi K, Hasegawa H, Watanabe M, et al. (2012) Usefulness of the preoperative administration of tegafur suppositories as alternative adjuvant chemotherapy for patients with resectable stage II or III colorectal cancer: a KODK4 multicenter randomized control trial. Oncology 83:16–23CrossRefPubMed
16.
go back to reference Rollven E, Holm T, Glimelius B, Lorinc E, Blomqvist L (2013) Potentials of high resolution magnetic resonance imaging versus computed tomography for preoperative local staging of colon cancer. Acta Radiol 54:722–730CrossRefPubMed Rollven E, Holm T, Glimelius B, Lorinc E, Blomqvist L (2013) Potentials of high resolution magnetic resonance imaging versus computed tomography for preoperative local staging of colon cancer. Acta Radiol 54:722–730CrossRefPubMed
17.
go back to reference Hunter C, Siddiqui M, Georgiou Delisle T, et al. (2017) CT and 3-T MRI accurately identify T3c disease in colon cancer, which strongly predicts disease-free survival. Clin Radiol 72:307–315CrossRefPubMed Hunter C, Siddiqui M, Georgiou Delisle T, et al. (2017) CT and 3-T MRI accurately identify T3c disease in colon cancer, which strongly predicts disease-free survival. Clin Radiol 72:307–315CrossRefPubMed
18.
go back to reference Nerad E, Lambregts DMJ, Kersten EL, et al. (2017) MRI for Local Staging of Colon Cancer: Can MRI Become the Optimal Staging Modality for Patients With Colon Cancer? Dis Colon Rectum 60:385–392CrossRefPubMed Nerad E, Lambregts DMJ, Kersten EL, et al. (2017) MRI for Local Staging of Colon Cancer: Can MRI Become the Optimal Staging Modality for Patients With Colon Cancer? Dis Colon Rectum 60:385–392CrossRefPubMed
19.
go back to reference Sobin LH, Fleming ID. TNM Classification of Malignant Tumors, fifth edition (1997). Union Internationale Contre le Cancer and the American Joint Committee on Cancer. Cancer 80:1803-1804 Sobin LH, Fleming ID. TNM Classification of Malignant Tumors, fifth edition (1997). Union Internationale Contre le Cancer and the American Joint Committee on Cancer. Cancer 80:1803-1804
20.
go back to reference Cho SH, Kim SH, Bae JH, et al. (2014) Prognostic stratification by extramural depth of tumor invasion of primary rectal cancer based on the Radiological Society of North America proposal. AJR Am J Roentgenol 202:1238–1244CrossRefPubMed Cho SH, Kim SH, Bae JH, et al. (2014) Prognostic stratification by extramural depth of tumor invasion of primary rectal cancer based on the Radiological Society of North America proposal. AJR Am J Roentgenol 202:1238–1244CrossRefPubMed
21.
go back to reference KSAR Study Group for Rectal Cancer (2016) Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology. Korean J Radiol 18:132–151CrossRef KSAR Study Group for Rectal Cancer (2016) Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology. Korean J Radiol 18:132–151CrossRef
22.
go back to reference Ashraf K, Ashraf O, Haider Z, Rafique Z (2006) Colorectal carcinoma, preoperative evaluation by spiral computed tomography. J Pak Med Assoc 56:149–153PubMed Ashraf K, Ashraf O, Haider Z, Rafique Z (2006) Colorectal carcinoma, preoperative evaluation by spiral computed tomography. J Pak Med Assoc 56:149–153PubMed
23.
go back to reference Brown G, Richards CJ, Bourne MW, et al. (2003) Morphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison. Radiology 227:371–377CrossRefPubMed Brown G, Richards CJ, Bourne MW, et al. (2003) Morphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison. Radiology 227:371–377CrossRefPubMed
24.
go back to reference Kim JH, Beets GL, Kim MJ, Kessels AG, Beets-Tan RG (2004) High-resolution MR imaging for nodal staging in rectal cancer: are there any criteria in addition to the size? Eur J Radiol 52:78–83CrossRefPubMed Kim JH, Beets GL, Kim MJ, Kessels AG, Beets-Tan RG (2004) High-resolution MR imaging for nodal staging in rectal cancer: are there any criteria in addition to the size? Eur J Radiol 52:78–83CrossRefPubMed
25.
go back to reference Smith NJ, Barbachano Y, Norman AR, et al. (2008) Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer. Br J Surg 95:229–236CrossRefPubMed Smith NJ, Barbachano Y, Norman AR, et al. (2008) Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer. Br J Surg 95:229–236CrossRefPubMed
26.
go back to reference Kirsch R, Messenger DE, Riddell RH, et al. (2013) Venous invasion in colorectal cancer: impact of an elastin stain on detection and interobserver agreement among gastrointestinal and nongastrointestinal pathologists. Am J Surg Pathol 37:200–210CrossRefPubMed Kirsch R, Messenger DE, Riddell RH, et al. (2013) Venous invasion in colorectal cancer: impact of an elastin stain on detection and interobserver agreement among gastrointestinal and nongastrointestinal pathologists. Am J Surg Pathol 37:200–210CrossRefPubMed
27.
go back to reference Vliegen RF, Beets GL, von Meyenfeldt MF, et al. (2005) Rectal cancer: MR imaging in local staging–is gadolinium-based contrast material helpful? Radiology 234:179–188CrossRefPubMed Vliegen RF, Beets GL, von Meyenfeldt MF, et al. (2005) Rectal cancer: MR imaging in local staging–is gadolinium-based contrast material helpful? Radiology 234:179–188CrossRefPubMed
28.
go back to reference Gollub MJ, Lakhman Y, McGinty K, et al. (2015) Does gadolinium-based contrast material improve diagnostic accuracy of local invasion in rectal cancer MRI? A multireader study. AJR Am J Roentgenol 204:W160–W167CrossRefPubMedPubMedCentral Gollub MJ, Lakhman Y, McGinty K, et al. (2015) Does gadolinium-based contrast material improve diagnostic accuracy of local invasion in rectal cancer MRI? A multireader study. AJR Am J Roentgenol 204:W160–W167CrossRefPubMedPubMedCentral
29.
go back to reference Beets-Tan RGH, Lambregts DMJ, Maas M, et al. (2018) Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol 28:1465–1475CrossRefPubMed Beets-Tan RGH, Lambregts DMJ, Maas M, et al. (2018) Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol 28:1465–1475CrossRefPubMed
30.
go back to reference Nerad E, Lahaye MJ, Maas M, et al. (2016) Diagnostic Accuracy of CT for Local Staging of Colon Cancer: A Systematic Review and Meta-Analysis. AJR Am J Roentgenol 207:984–995CrossRefPubMed Nerad E, Lahaye MJ, Maas M, et al. (2016) Diagnostic Accuracy of CT for Local Staging of Colon Cancer: A Systematic Review and Meta-Analysis. AJR Am J Roentgenol 207:984–995CrossRefPubMed
31.
go back to reference Gollub MJ, Arya S, Beets-Tan RG, et al. (2018) Use of magnetic resonance imaging in rectal cancer patients: Society of Abdominal Radiology (SAR) rectal cancer disease-focused panel (DFP) recommendations 2017. Abdom Radiol 43:2893–2902CrossRef Gollub MJ, Arya S, Beets-Tan RG, et al. (2018) Use of magnetic resonance imaging in rectal cancer patients: Society of Abdominal Radiology (SAR) rectal cancer disease-focused panel (DFP) recommendations 2017. Abdom Radiol 43:2893–2902CrossRef
Metadata
Title
Diagnostic performance of MRI- versus MDCT-categorized T3cd/T4 for identifying high-risk stage II or stage III colon cancers: a pilot study
Authors
Soo Yeun Park
Seung Hyun Cho
Min A. Lee
Ghilsuk Yoon
Hye Jin Kim
Jun Seok Park
Won Hwa Kim
So Mi Lee
Kyung-Min Shin
Hye Jung Kim
Gab Chul Kim
See Hyung Kim
Gyu-Seog Choi
Publication date
01-05-2019
Publisher
Springer US
Published in
Abdominal Radiology / Issue 5/2019
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1822-7

Other articles of this Issue 5/2019

Abdominal Radiology 5/2019 Go to the issue

Classics in Abdominal Radiology

Sentinel clot sign in hemoperitoneum

Classics in Abdominal Radiology

The “maiden waist” sign of the ureters