Prognostic Aspects of DCE-MRI in Recurrent Rectal Cancer
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To explore whether pre-reoperative dynamic contrast-enhanced (DCE)-MRI findings correlate with clinical outcome in patients who undergo surgical treatment for recurrent rectal carcinoma.
A retrospective study of DCE-MRI in patients with recurrent rectal cancer was performed after obtaining an IRB waiver. We queried our PACS from 1998 to 2012 for examinations performed for recurrent disease. Two radiologists in consensus outlined tumour regions of interest on perfusion images. We explored the correlation between Ktrans, Kep, Ve, AUC90 and AUC180 with time to re-recurrence of tumour, overall survival and resection margin status. Univariate Cox PH models were used for survival, while univariate logistic regression was used for margin status.
Among 58 patients with pre-treatment DCE-MRI who underwent resection, 36 went directly to surgery and 18 had positive margins. Ktrans (0.55, P = 0.012) and Kep (0.93, P = 0.04) were inversely correlated with positive margins. No significant correlations were noted between Ktrans, Kep, Ve, AUC90 and AUC180 and overall survival or time to re-recurrence of tumour.
Ktrans and Kep were significantly associated with clear resection margins; however overall survival and time to re-recurrence were not predicted. Such information might be helpful for treatment individualisation and deserves further investigation.
• Morphological MRI features are not sufficiently predictive of complete rectal tumour resection.
• Survival and time to re-recurrence of tumour were not predicted by DCE-MRI.
• But perfusion data from dynamic enhanced MRI may provide more helpful information.
• Ktrans/Kep were shown to be significantly associated with clear resection margins.
• Functional information from DCE-MRI might be helpful for treatment individualisation.
KeywordsRectal cancer DCE-MRI Recurrence Biomarker Resection margin
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