CME JOURNAL OF MAGNETIC RESONANCE IMAGING 00:00–00 (2013)
Original Research
Extramural Depth of Tumor Invasion at Thin-Section MR in Rectal Cancer: Associating With Prognostic Factors and ADC Value Tong Tong, MD,1y Zhenwei Yao, MD,2y Linhui Xu, BS,1 Sanjun Cai, MD,3 Rui Bi, MS,4 Chao Xin, BS,1 Yajia Gu, MD,1* and Weijun Peng, MD1* Conclusion: Significant correlations were found between EMD values and CEA, CA19-9 level, differentiation grade and ADC value. As been found, higher EMD values were associated with a more aggressive tumor profile and, therefore, EMD has the potential to become an imaging biomarker of tumor aggressiveness indicator.
Purpose: To assess the value of maximal extramural depth (EMD) of T3 tumor spread on MRI as a potential noninvasive imaging biomarker of tumor aggressiveness in rectal cancer, by analyzing the relationship between tumoral EMD values and clinical or histological prognostic parameters. In addition, we try to investigate the relationship between EMD and apparent diffusion coefficient (ADC) values.
Key Words: MRI; depth of invasion; diffusion-weighted imaging; rectal cancer; prognosis J. Magn. Reson. Imaging 2013;00:000–000. C 2013 Wiley Periodicals, Inc. V
Materials and Methods: Ninety rectal cancer patients who underwent primary MRI staging and diffusion weighted imaging (DWI) as T3 tumor were included. Tumor EMD was measured, and the EMD values of the subgroups based on pretreatment CEA, CA19-9 levels, N stage, and histological parameters were compared. The correlation between EMD and ADC values was compared.
DEPTH OF TUMOR invasion outside the muscularis propria is not considered in tumor, node, metastases (TNM)staging; however, it has substantial clinical significance (1). The majority (80%) of rectal tumors are stage T3 lesions that form a heterogeneous group, with the 5-year survival rates variation based on the depth of tumor invasion outside the muscularis propria. The cancer-specific survival rate drops from 85% to 54%, independent of nodal involvement, when the depth of tumor invasion outside the muscularis propria exceeds 5 mm (2). The current trends in the treatment of rectal cancer point toward a more widespread acceptance of neoadjuvant therapies. This creates an increasing need for preoperative imaging methods to noninvasively select high-risk patients who could benefit from the more aggressive multimodality treatment approaches (3,4). The definitions of stage T3a–T3c tumors have been taken from the standardized MR reporting criteria and incorporated into the Radiological Society of North America’s radiology reporting template for primary rectal cancer (T3a:tumor extends
Original Research
Extramural Depth of Tumor Invasion at Thin-Section MR in Rectal Cancer: Associating With Prognostic Factors and ADC Value Tong Tong, MD,1y Zhenwei Yao, MD,2y Linhui Xu, BS,1 Sanjun Cai, MD,3 Rui Bi, MS,4 Chao Xin, BS,1 Yajia Gu, MD,1* and Weijun Peng, MD1* Conclusion: Significant correlations were found between EMD values and CEA, CA19-9 level, differentiation grade and ADC value. As been found, higher EMD values were associated with a more aggressive tumor profile and, therefore, EMD has the potential to become an imaging biomarker of tumor aggressiveness indicator.
Purpose: To assess the value of maximal extramural depth (EMD) of T3 tumor spread on MRI as a potential noninvasive imaging biomarker of tumor aggressiveness in rectal cancer, by analyzing the relationship between tumoral EMD values and clinical or histological prognostic parameters. In addition, we try to investigate the relationship between EMD and apparent diffusion coefficient (ADC) values.
Key Words: MRI; depth of invasion; diffusion-weighted imaging; rectal cancer; prognosis J. Magn. Reson. Imaging 2013;00:000–000. C 2013 Wiley Periodicals, Inc. V
Materials and Methods: Ninety rectal cancer patients who underwent primary MRI staging and diffusion weighted imaging (DWI) as T3 tumor were included. Tumor EMD was measured, and the EMD values of the subgroups based on pretreatment CEA, CA19-9 levels, N stage, and histological parameters were compared. The correlation between EMD and ADC values was compared.
DEPTH OF TUMOR invasion outside the muscularis propria is not considered in tumor, node, metastases (TNM)staging; however, it has substantial clinical significance (1). The majority (80%) of rectal tumors are stage T3 lesions that form a heterogeneous group, with the 5-year survival rates variation based on the depth of tumor invasion outside the muscularis propria. The cancer-specific survival rate drops from 85% to 54%, independent of nodal involvement, when the depth of tumor invasion outside the muscularis propria exceeds 5 mm (2). The current trends in the treatment of rectal cancer point toward a more widespread acceptance of neoadjuvant therapies. This creates an increasing need for preoperative imaging methods to noninvasively select high-risk patients who could benefit from the more aggressive multimodality treatment approaches (3,4). The definitions of stage T3a–T3c tumors have been taken from the standardized MR reporting criteria and incorporated into the Radiological Society of North America’s radiology reporting template for primary rectal cancer (T3a:tumor extends
