MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal
Modern studies focus on the discovery of innovative methods to improve the value of post-treatment magnetic resonance imaging (MRI) in the prediction of pathological responses to preoperative neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC)<b>.</b> The aim of...
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MDPI AG
2023-10-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/20/3226 |
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| author | Aleksandra Jankovic Jelena Djokic Kovac Marko Dakovic Milica Mitrovic Dusan Saponjski Ognjen Milicevic Aleksandra Djuric-Stefanovic Goran Barisic |
| author_facet | Aleksandra Jankovic Jelena Djokic Kovac Marko Dakovic Milica Mitrovic Dusan Saponjski Ognjen Milicevic Aleksandra Djuric-Stefanovic Goran Barisic |
| author_sort | Aleksandra Jankovic |
| collection | DOAJ |
| description | Modern studies focus on the discovery of innovative methods to improve the value of post-treatment magnetic resonance imaging (MRI) in the prediction of pathological responses to preoperative neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC)<b>.</b> The aim of this study was to assess the potential benefits of combining magnetic resonance tumor regression grade (mrTRG) with T2-weighted volumetry in the prediction of pathological responses to nCRT in LARC. This was a cohort study conducted on patients with histopathologically confirmed LARC in a period from 2020 to 2022. After histopathological verification, all patients underwent initial MRI studies, while the follow-up MRI was performed after nCRT. Tumor characteristics, MRI estimated tumor regression grade (mrTRG) and tumor volumetry were evaluated both initially and at follow-up. All patients were classified into responders and non-responders according to pathological tumor regression grade (pTRG) and mrTRG. A total of 71 patients, mostly male (66.2%) were included in the study. The median tumor volume reduction rate was significantly higher in nCRT-responders compared to non-responders (79.9% vs. 63.3%) (<i>p</i> = 0.003). Based on ROC analysis, optimal cut-off value for tumor volume reduction rate was determined with an area under the curve (AUC) value of 0.724 (<i>p</i> = 0.003). Using the tumor volume reduction rate ≥75% with the addition of response to nCRT according to mrTRG, a new scoring system for prediction of pTRG to preoperative nCRT in LARC was developed. Diagnostic performance of prediction score was tested and the sensitivity, PPV, specificity, and NPV were 81.8%, 56.3%, 71.4%, and 89.7%, respectively. The combination of mrTRG and T2-weighted volumetry increases the MRI-based prediction of pTRG to preoperative nCRT in LARC. The proposed scoring system could aid in distinguishing responders to nCRT, as these patients could benefit from organ-preserving treatment and a “watch and wait” strategy. |
| first_indexed | 2024-03-10T21:18:18Z |
| format | Article |
| id | doaj.art-1e512a6dfbd34ec49a93767e40049e23 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T21:18:18Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-1e512a6dfbd34ec49a93767e40049e232023-11-19T16:13:05ZengMDPI AGDiagnostics2075-44182023-10-011320322610.3390/diagnostics13203226MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System ProposalAleksandra Jankovic0Jelena Djokic Kovac1Marko Dakovic2Milica Mitrovic3Dusan Saponjski4Ognjen Milicevic5Aleksandra Djuric-Stefanovic6Goran Barisic7Department for Digestive Radiology, Center for Radiology, University Clinical Center of Serbia, Pasterova No. 2, 11000 Belgrade, SerbiaDepartment for Digestive Radiology, Center for Radiology, University Clinical Center of Serbia, Pasterova No. 2, 11000 Belgrade, SerbiaFaculty of Physical Chemistry, University of Belgrade, 11000 Belgrade, SerbiaDepartment for Digestive Radiology, Center for Radiology, University Clinical Center of Serbia, Pasterova No. 2, 11000 Belgrade, SerbiaDepartment for Digestive Radiology, Center for Radiology, University Clinical Center of Serbia, Pasterova No. 2, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr. Subotica No. 8, 11000 Belgrade, SerbiaDepartment for Digestive Radiology, Center for Radiology, University Clinical Center of Serbia, Pasterova No. 2, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr. Subotica No. 8, 11000 Belgrade, SerbiaModern studies focus on the discovery of innovative methods to improve the value of post-treatment magnetic resonance imaging (MRI) in the prediction of pathological responses to preoperative neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC)<b>.</b> The aim of this study was to assess the potential benefits of combining magnetic resonance tumor regression grade (mrTRG) with T2-weighted volumetry in the prediction of pathological responses to nCRT in LARC. This was a cohort study conducted on patients with histopathologically confirmed LARC in a period from 2020 to 2022. After histopathological verification, all patients underwent initial MRI studies, while the follow-up MRI was performed after nCRT. Tumor characteristics, MRI estimated tumor regression grade (mrTRG) and tumor volumetry were evaluated both initially and at follow-up. All patients were classified into responders and non-responders according to pathological tumor regression grade (pTRG) and mrTRG. A total of 71 patients, mostly male (66.2%) were included in the study. The median tumor volume reduction rate was significantly higher in nCRT-responders compared to non-responders (79.9% vs. 63.3%) (<i>p</i> = 0.003). Based on ROC analysis, optimal cut-off value for tumor volume reduction rate was determined with an area under the curve (AUC) value of 0.724 (<i>p</i> = 0.003). Using the tumor volume reduction rate ≥75% with the addition of response to nCRT according to mrTRG, a new scoring system for prediction of pTRG to preoperative nCRT in LARC was developed. Diagnostic performance of prediction score was tested and the sensitivity, PPV, specificity, and NPV were 81.8%, 56.3%, 71.4%, and 89.7%, respectively. The combination of mrTRG and T2-weighted volumetry increases the MRI-based prediction of pTRG to preoperative nCRT in LARC. The proposed scoring system could aid in distinguishing responders to nCRT, as these patients could benefit from organ-preserving treatment and a “watch and wait” strategy.https://www.mdpi.com/2075-4418/13/20/3226magnetic resonance imagingrespondersnon-respondersrectal cancermagnetic resonance volumetry |
| spellingShingle | Aleksandra Jankovic Jelena Djokic Kovac Marko Dakovic Milica Mitrovic Dusan Saponjski Ognjen Milicevic Aleksandra Djuric-Stefanovic Goran Barisic MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal Diagnostics magnetic resonance imaging responders non-responders rectal cancer magnetic resonance volumetry |
| title | MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal |
| title_full | MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal |
| title_fullStr | MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal |
| title_full_unstemmed | MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal |
| title_short | MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal |
| title_sort | mri tumor regression grade combined with t2 weighted volumetry may predict histopathological response in locally advanced rectal cancer following neoadjuvant chemoradiotherapy a new scoring system proposal |
| topic | magnetic resonance imaging responders non-responders rectal cancer magnetic resonance volumetry |
| url | https://www.mdpi.com/2075-4418/13/20/3226 |
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