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

 Seung Hyun Park  ;  Joon Seok Lim  ;  Jinae Lee  ;  Ha Yan Kim  ;  Woong Sub Koom  ;  Hyuk Hur  ;  Mi-Suk Park  ;  Myeong-Jin Kim  ;  Honsoul Kim  
 RADIOLOGY, Vol.285(1) : 124-133, 2017 
Journal Title
Issue Date
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
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.
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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) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Ha Yan(김하얀)
Kim, Hon Soul(김한솔)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Seung Hyun(박승현)
Lee, Jinae(이진애)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
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