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Rectal Mucinous Adenocarcinoma: MR Imaging Assessment of Response to Concurrent Chemotherapy and Radiation Therapy-A Hypothesis-generating Study

Authors
 Seung Hyun Park  ;  Joon Seok Lim  ;  Jinae Lee  ;  Ha Yan Kim  ;  Woong Sub Koom  ;  Hyuk Hur  ;  Mi-Suk Park  ;  Myeong-Jin Kim  ;  Honsoul Kim  
Citation
 Radiology, Vol.285(1) : 124-133, 2017 
Journal Title
 Radiology 
ISSN
 0033-8419 
Issue Date
2017
MeSH
Adenocarcinoma, Mucinous*/diagnostic imaging ; Adenocarcinoma, Mucinous*/drug therapy ; Adenocarcinoma, Mucinous*/mortality ; Adenocarcinoma, Mucinous*/radiotherapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Rectal Neoplasms*/diagnostic imaging ; Rectal Neoplasms*/drug therapy ; Rectal Neoplasms*/mortality ; Rectal Neoplasms*/radiotherapy ; Retrospective Studies ; Young Adult
Abstract
Purpose To develop a system for assessment of tumor regression grade (TRG) with magnetic resonance (MR) imaging that is applicable to rectal mucinous adenocarcinoma (RMAC) and to obtain a preliminary evaluation of the association of MR imaging assessment of TRG with response to preoperative concurrent chemotherapy and radiation therapy (CCRT). Materials and Methods This retrospective study was approved by the institutional review board, and informed consent was waived. Pre- and post-CCRT MR images of 59 patients with RMAC (median age, 59 years; range, 29-80 years; 42 men [median age, 59 years; range, 36-80 years] and 17 women [median age, 57 years; range, 29-79 years]) who underwent CCRT and subsequent elective resection from July 2005 to June 2015 were analyzed. Two experienced gastrointestinal radiologists independently analyzed imaging parameters such as T stage, mesorectal fascia status, extramural vascular invasion status, and TRG by using modified criteria developed for assessment of RMAC. Interobserver variability was calculated with weighted κ analysis, and disagreement was settled in consensus. MR imaging TRG results were compared with those from pathologic TRG analysis (Mandard grade). Logistic regression analyses were performed to evaluate associations between imaging parameters and pathologic TRG. Results There was moderate to substantial agreement for imaging parameters (post-CCRT T stage-weighted κ, 0.7134; post-CCRT mesorectal fascia status, 0.618; TRG, 0.5023). Modified MR imaging TRG results were significantly associated with pathologic responsiveness (responsive group, Mandard grade 1 or 2; nonresponsive group, Mandard grades 3-5; P = .023). Results of univariate and multivariate logistic regression analyses indicated that MR imaging TRG was the only factor significantly associated with CCRT responsiveness (univariate analysis, P = .023; multivariate analysis, P = .0261). Conclusion The modified MR imaging assessment of TRG was associated with treatment response to CCRT in patients with RMAC. © RSNA, 2017 Online supplemental material is available for this article.
Full Text
https://pubs.rsna.org/doi/10.1148/radiol.2017162657
DOI
10.1148/radiol.2017162657
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
금웅섭(Koom, Woong Sub) ORCID logo https://orcid.org/0000-0002-9435-7750
김명진(Kim, Myeong Jin) ORCID logo https://orcid.org/0000-0001-7949-5402
김하얀(Kim, Ha Yan)
김한솔(Kim, Hon Soul)
박미숙(Park, Mi-Suk) ORCID logo https://orcid.org/0000-0001-5817-2444
박승현(Park, Seung Hyun)
이진애(Lee, Jinae)
임준석(Lim, Joon Seok) ORCID logo https://orcid.org/0000-0002-0334-5042
허혁(Hur, Hyuk) ORCID logo https://orcid.org/0000-0002-9864-7229
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161102
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