Assessment of remaining tumour involved lymph nodes with MRI in patients with complete luminal response after neoadjuvant treatment of rectal cancer

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Loftås, PerLinköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Hälsouniversitetet,Region Östergötland, Kirurgiska kliniken ViN (author)

Assessment of remaining tumour involved lymph nodes with MRI in patients with complete luminal response after neoadjuvant treatment of rectal cancer

Article/chapterEnglish2018

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2018-05-10
BRITISH INST RADIOLOGY,2018
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LIBRIS-ID:oai:DiVA.org:liu-149755
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-149755URI
https://doi.org/10.1259/bjr.20170938DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:138610293URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Objective: To assess the accuracy of MRI to predict remaining lymph node metastases in patients with complete pathological luminal response (ypTO) after neoadjuvant therapy. Methods: Data from a national registry were used. 19 patients with histopathologically remaining lymph node metastases (ypTON+) were identified. Another 19 patients without lymph node metastases (ypTONO) were used as matched controls. Two radiologists blinded to all patient information evaluated staging and restaging MRI that was compared to histopathological findings of the resected specimen. Results: The average size of the largest lymph node on restaging MRI was significantly larger (4.5 mm) in the ypTON+ group than in the ypTONO group (2.6 mm) (p = 0.04). Presence of ypN+ was correctly predicted by MRI in 7 of 19 patients. In patients without lymph node metastases (ypTONO), these were correctly classified by MRI in 16 of 19 patients. All patients who had MR-identified lymph nodes larger than 8mm at restaging were ypTN+. The sensitivity, specificity, positive predictive value and negative for prediction of remaining lymph node metastasis with MRI were 37, 84, 70 and 57%. Conclusion: In patients with ypTO in rectal cancer after neoadjuvant treatment, remaining regional lymph node metastases cannot safely be predicted by restaging MRI alone using presently known criteria. Presence of a lymph node over 8mm on restaging MRI strongly indicates yPN+. Advances In knowledge: This is one of the first studies on MRI lymph node assessment after chemo- radiotherapy (CRT) in luminal complete response.

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Sturludottir, MargretKarolinska Univ Hosp, Sweden; Karolinska Inst, Sweden (author)
Hallböök, OlofLinköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Hälsouniversitetet,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)oloha72 (author)
Almlöv, KarinLinköpings universitet,Institutionen för klinisk och experimentell medicin,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken ViN(Swepub:liu)karal79 (author)
Arbman, GunnarLinköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Region Östergötland, Kirurgiska kliniken ViN(Swepub:liu)gunar63 (author)
Blomqvist, LennartKarolinska Institutet,Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden (author)
Linköpings universitetAvdelningen för Kirurgi, Ortopedi och Onkologi (creator_code:org_t)

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In:British Journal of Radiology: BRITISH INST RADIOLOGY91:10870007-12851748-880X

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