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

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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.

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Acknowledgements

This work was supported by Biomedical Research Institute grant, Kyungpook National University Hospital (2016). We would like to express special thanks of gratitude to Professor Won Kee Lee, Ph.D., who helped us to solve the statistical problem.

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Author notes

  1. Seung Hyun Cho and Gyu-Seog Choi contributed equally to this research as corresponding authors.

Authors and Affiliations

  1. Colorectal Cancer Centre, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea

    Soo Yeun Park, Hye Jin Kim, Jun Seok Park & Gyu-Seog Choi

  2. Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea

    Seung Hyun Cho, Min A. Lee, Won Hwa Kim, So Mi Lee, Kyung-Min Shin, Hye Jung Kim & Gab Chul Kim

  3. Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

    Ghilsuk Yoon

  4. Department of Radiology, Dongsan Hospital, College of Medicine, Keimyung University, Daegu, Republic of Korea

    See Hyung Kim

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  1. Soo Yeun Park
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Correspondence to Seung Hyun Cho or Gyu-Seog Choi.

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Park, S.Y., Cho, S.H., Lee, M.A. et al. Diagnostic performance of MRI- versus MDCT-categorized T3cd/T4 for identifying high-risk stage II or stage III colon cancers: a pilot study. Abdom Radiol 44, 1675–1685 (2019). https://doi.org/10.1007/s00261-018-1822-7

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