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Validation of the standardized index of shape tool to analyze DCE-MRI data in the assessment of neo-adjuvant therapy in locally advanced rectal cancer

  • Diagnostic Imaging in Oncology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

Standardized index of shape (SIS) tool validation to examine dynamic contrast enhanced–magnetic resonance imaging (DCE-MRI) in preoperative chemo-radiation therapy (pCRT) assessment of locally advanced rectal cancer (LARC) in order to guide the surgeon versus more or less conservative treatment.

Materials and Methods

A total of 194 patients (January 2008–November 2020), with III-IV locally advanced rectal cancer and subjected to pCRT were included. Three expert radiologists performed DCE-MRI analysis using SIS tool. Degree of absolute agreement among measurements, degree of consistency among measurements, degree of reliability and level of variability were calculated. Patients with a pathological tumour regression grade (TRG) 1 or 2 were classified as major responders (complete responders have TRG 1).

Results

Good significant correlation was obtained between SIS measurements (range 0.97–0.99). The degree of absolute agreement ranges from 0.93 to 0.99, the degree of consistency from 0.81 to 0.9 and the reliability from 0.98 to 1.00 (p value <  < 0.001). The variability coefficient ranges from 3.5% to 26%. SIS value obtained to discriminate responders by non-responders a sensitivity of 95.9%, a specificity of 84.7% and an accuracy of 91.8% while to detect complete responders, a sensitivity of 99.2%, a specificity of 63.9% and an accuracy of 86.1%.

Conclusion

SIS tool is suitable to assess pCRT response both to identify major responders and complete responders in order to guide the surgeon versus more or less conservative treatment.

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Authors and Affiliations

  1. Radiology Unit, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131, Naples, Italy

    Roberta Fusco, Vincenza Granata & Antonella Petrillo

  2. Department of Electrical Engineering and Information Technologies, University Federico II of Naples, Via Claudio, Naples, Italy

    Mario Sansone

  3. Gastrointestinal Surgical Oncology Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131, Naples, Italy

    Daniela Rega & Paolo Delrio

  4. Diagnostic Pathology Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131, Naples, Italy

    Fabiana Tatangelo

  5. Gastrointestinal Medical Oncology Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131, Naples, Italy

    Carmen Romano & Antonio Avallone

  6. Division of Radiology, Università Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy

    Davide Pupo, Marzia Giordano & Roberto Grassi

  7. Radiotherapy Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131, Naples, Italy

    Vincenzo Ravo & Biagio Pecori

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  1. Roberta Fusco
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  2. Vincenza Granata
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  3. Mario Sansone
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  8. Antonio Avallone
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  9. Davide Pupo
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  10. Marzia Giordano
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  11. Roberto Grassi
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Correspondence to Roberta Fusco.

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Fusco, R., Granata, V., Sansone, M. et al. Validation of the standardized index of shape tool to analyze DCE-MRI data in the assessment of neo-adjuvant therapy in locally advanced rectal cancer. Radiol med 126, 1044–1054 (2021). https://doi.org/10.1007/s11547-021-01369-1

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