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- Title
Improving staging of rectal cancer in the pelvis: the role of PET/MRI.
- Authors
Catalano, Onofrio A.; Lee, Susanna I.; Parente, Chiara; Cauley, Christy; Furtado, Felipe S.; Striar, Robin; Soricelli, Andrea; Salvatore, Marco; Li, Yan; Umutlu, Lale; Cañamaque, Lina Garcia; Groshar, David; Mahmood, Umar; Blaszkowsky, Lawrence S.; Ryan, David P.; Clark, Jeffrey W.; Wo, Jennifer; Hong, Theodore S.; Kunitake, Hiroko; Bordeianou, Liliana
- Abstract
Purpose: The role of positron emission tomography/magnetic resonance (PET/MR) in evaluating the local extent of rectal cancer remains uncertain. This study aimed to investigate the possible role of PET/MR versus magnetic resonance (MR) in clinically staging rectal cancer. Methods: This retrospective two-center cohort study of 62 patients with untreated rectal cancer investigated the possible role of baseline staging PET/MR versus stand-alone MR in determination of clinical stage. Two readers reviewed T and N stage, mesorectal fascia involvement, tumor length, distance from the anal verge, sphincter involvement, and extramural vascular invasion (EMVI). Sigmoidoscopy, digital rectal examination, and follow-up imaging, along with surgery when available, served as the reference standard. Results: PET/MR outperformed MR in evaluating tumor size (42.5 ± 21.03 mm per the reference standard, 54 ± 20.45 mm by stand-alone MR, and 44 ± 20 mm by PET/MR, P = 0.004), and in identifying N status (correct by MR in 36/62 patients [58%] and by PET/MR in 49/62 cases [79%]; P = 0.02) and external sphincter infiltration (correct by MR in 6/10 and by PET/MR in 9/10; P = 0.003). No statistically significant differences were observed in relation to any other features. Conclusion: PET/MR provides a more precise assessment of the local extent of rectal cancers in evaluating cancer length, N status, and external sphincter involvement. PET/MR offers the opportunity to improve clinical decision-making, especially when evaluating low rectal tumors with possible external sphincter involvement.
- Subjects
RECTAL cancer; ENDORECTAL ultrasonography; DIGITAL rectal examination; POSITRON emission tomography; TUMOR classification; MAGNETIC resonance imaging; RECTUM
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2021, Vol 48, Issue 4, p1235
- ISSN
1619-7070
- Publication type
Academic Journal
- DOI
10.1007/s00259-020-05036-x