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首页> 外文期刊>Abdominal radiology. >Primary and post-chemoradiotherapy staging using MRI in rectal cancer: the role of diffusion imaging in the assessment of perirectal infiltration
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Primary and post-chemoradiotherapy staging using MRI in rectal cancer: the role of diffusion imaging in the assessment of perirectal infiltration

机译：在直肠癌中使用MRI的小学和化学疗法分期：扩散成像在评估北北渗透时的作用

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Purpose To analyze changes in MRI diagnostic accuracy in main rectal tumor (T) evaluation resulting from the use of diffusion-weighted imaging (DWI), according to the degree of experience of the radiologist. Methods This is a cross-sectional study of a database including one hundred 1.5 T MRI records (2011-2016) from patients with biopsy-proven rectal cancer, including primary staging and post-chemoradiotherapy follow-up. All cases were individually blindedly reviewed by ten radiologists: three experienced in rectal cancer, three specialized in other areas, and four residents. Each case was assessed twice to detect perirectal infiltration: first, evaluating just high-resolution T2-weighted sequences (HRT2w); second, evaluation of DWI plus HRT2w sequences. Results were pooled by experience, calculating accuracy (area under ROC curve), sensitivity and specificity, predictive values, likelihood ratios, and overstaging/understag-ing. Histology of surgical specimens provided the reference standard. Results DWI significantly improved specificity by experienced radiologists in primary staging (63.2% to 75.9%) and, to a lesser extent, positive likelihood ratio (2.06 to 2.87); minimal changes were observed post-chemoradiotherapy, with a slight decrease of accuracy (0.657 to 0.626). Inexperienced radiologists showed a similar pattern, but with slight enhancement post-chemoradiotherapy (accuracy 0.604 to 0.621). Residents experienced small changes, with increased sensitivity/ decreased specificity in both primary (69% to 72%/67.2% to 64.7%) and post-chemoradiotherapy (68.1% to 73.6%/47.3% to 44.6%) staging. Conclusions Adding DWI to HRT2w significantly improved specificity for the detection of perirectal infiltration at primary staging by experienced radiologists and also by inexperienced ones, although to a lesser extent. In the post-neoadjuvant treatment subgroup, only minimal changes were observed.
机译：目的分析在从使用扩散加权成像（DWI）的所得主直肠肿瘤（T）评价MRI诊断准确性的变化，根据放射科医生的经验的程度。方法这是包括患者的活检证实直肠癌，包括主舞台和后放化疗随访百1.5T的MRI记录（2011至2016年）的数据库的横断面研究。所有病例均单独盲法十放射科审查：三位经验丰富的直肠癌，专业从事其他区域的三个和四个居民。每一种情况下被评估两次，以检测直肠周围浸润：第一，评估只是高分辨率T2加权的序列（HRT2w）;第二，DWI加HRT2w序列的评价。结果由经验汇集，计算精度（面积ROC曲线下），敏感性和特异性，预测值，似然比，并且过度分期/ understag-ING。手术标本的组织学提供的参考标准。结果通过在主分段（63.2％至75.9％），以及在较小程度上，阳性似然比（2.06至2.87）有经验的放射科医师DWI显著改善的特异性;最小的变化，观察到-化疗后，具有精度的轻微下降（0.657至0.626）。没有经验的放射科医师显示了类似的模式，但有轻微改善后的放化疗（精度0.604至0.621）。居民经历小的变化，具有增加的灵敏度/在两个主降低特异性（69％至72％/ 67.2％64.7％）和后放化疗（68.1％至73.6％/ 47.3％至44.6％）分期。结论添加到DWI HRT2w显著改善特异性在由有经验的放射科医师主分段检测直肠周围浸润的，并且还由无经验的那些，尽管在较小的程度。在-新辅助治疗后亚组，仅观察到最小的变化。

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