Accuracy of MRI for predicting anterior peritoneal reflection involvement in locally advanced rectal cancer: a comparison with operative findings
- Sim, Ki Choon; Park, Beom Jin; Kim, Min Ju; Sung, Deuk Jae; Han, Na Yeon; Han, Yeo Eun; Kwak, Jung-Myun; An, Hyonggin
- Issue Date
- Springer New York
- Rectal neoplasms; Anterior peritoneal reflection; Magnetic resonance imaging; Accuracy
- Abdominal Radiology, v.47, no.2, pp.508 - 516
- Journal Title
- Abdominal Radiology
- Start Page
- End Page
To assess the diagnostic accuracy of preoperative rectal MRI for anterior peritoneal reflection (APR) involvement in rectal cancer through comparison with the surgeon’s operative findings.
This retrospective study was approved by the institutional review board; informed consent was waived. We enrolled 55 consecutive patients with suspected locally advanced mid-to-upper rectal cancer. All patients underwent rectal MRI using a 3T system. APR involvement in rectal cancer was assessed radiologically using a 5-point scale by two independent board-certified abdominal radiologists. The surgeon’s evaluation during surgery was regarded as the gold standard for APR involvement. The accuracy of rectal MRI in predicting APR involvement was obtained.
Rectal MRI showed good APR identification (rater 1, 92.7%; rater 2, 94.7%). On preoperative rectal MRI, rater 1 diagnosed 19 (34.5%) patients as having APR involvement and rater 2 diagnosed 28 (50.9%) as having APR involvement. There was moderate agreement (κ = 0.602, p < 0.001) between the two raters with regard to the evaluation of APR involvement. During surgery, the surgeon confirmed APR involvement in 13 (23.6%) patients. The sensitivity, specificity, PPV, and NPV of preoperative MRI for APR involvement were 69.2%, 76.2%, 47.4%, and 88.9%, respectively. The diagnostic accuracy of MRI for predicting APR involvement was 74.6%.
Preoperative rectal MRI provides accurate anatomical information regarding APR involvement with high conspicuity. However, MRI has relatively low sensitivity (< 70%) and a low PPV (< 50%) with regard to the assessment of APR involvement in rectal tumors.
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- 1. Basic Science > Department of Biostatistics > 1. Journal Articles
- 2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles
- 2. Clinical Science > Department of Radiology > 1. Journal Articles
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