Accuracy of Baseline Magnetic Resonance Imaging for Staging Rectal Cancer Patients Proceeding Directly to Surgery

Milanzi, E; Pelly, RM; Hayes, IP; Gibbs, P; Faragher, I; Reece, JC

Author(s): Milanzi, E; Pelly, RM; Hayes, IP; Gibbs, P; Faragher, I; Reece, JC;
Details: Publication Year 2024-12,Volume 130,Issue #8,Page 1674-1682
Journal Title: Journal of Surgical Oncology
Abstract: BACKGROUND AND OBJECTIVES: High-resolution magnetic resonance imaging (MRI) accuracy for staging preoperative rectal cancer varies across studies. We examined MRI accuracy for T- and N-staging of rectal cancer compared with final histopathology of the resected specimen in a large Australian cohort who did not receive neoadjuvant therapy or radiation. METHODS: Retrospective analysis of prospectively-collected clinical data from 153 rectal adenocarcinomas locally staged by high-resolution MRI between January 2012 and December 2019 that did not undergo chemoradiotherapy or radiation before surgery. T- and N-stage agreement between MRI and final histopathology was assessed using Kappa statistic. Agreement at each T-stage was evaluated using log-linear modeling. N-staging accuracy was examined using positive and negative predictive values. RESULTS: Overall agreement between MRI and final histopathology for T-stage and N-stage was 55% and 65%, respectively. Kappa statistic found higher agreement between MRI and final histopathology for T-staging (κ = 0.33) versus N-staging (κ = 0.18). MRI correctly assessed 91% of T1 tumors, 43% of T2 tumors, 65% of T3 tumors, and 80% of T4 tumors. MRI accuracy was higher for N-negative tumors (74.1%) than for N-positive tumors (44.4%). CONCLUSION: MRI is moderately accurate at staging T1, T3, and T4 rectal tumors but caution when staging tumors as T2 is advised. Greater accuracy for staging N-negative versus N-positive tumors is indicated.
Publisher: Wiley
Keywords: Humans; *Rectal Neoplasms/pathology/diagnostic imaging/surgery/therapy; *Magnetic Resonance Imaging/methods; Female; *Neoplasm Staging; Male; Retrospective Studies; Aged; Middle Aged; *Adenocarcinoma/diagnostic imaging/pathology/surgery; Adult; Aged, 80 and over; Follow-Up Studies; Prognosis; Prospective Studies; Mri; N‐stage; T‐stage; accuracy; rectal cancer
Research Division(s): Personalised Oncology
PubMed ID: 39233560
Publisher's Version: https://doi.org/10.1002/jso.27852
Open Access at Publisher's Site: https://doi.org/10.1002/jso.27852
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-03 09:13:28

Last Modified: 2025-04-10 10:03:14