Author of 2 Presentations
SS 8.8 - MR tumour regression grade with diffusion-weighted imaging in locally advanced rectal cancer compared with standard MR tumour regression grade and pathological tumour regression grade: feasibility and prognostic role
Abstract
Purpose
Evaluate the accuracy and the prognostic role of MR tumor regression grade (TRG) after neoadjuvant radiochemotherapy (RCT) in locally advanced rectal cancers (LARC) using T2 plus diffusion-weighted imaging (DWI) sequences (mrTRG_DWI) comparing to standard T2-only mrTRG and pathological TRG (pTRG).
Material and methods
36 patients were enrolled in this retrospective study, all underwent a pre- and post-CRT conventional MRI study followed by surgical resection with a median 36-month follow-up. A 5-point mrTRG and mrTRG_DWI were assessed by two expert radiologists and finally compared with pTRG.
Results
Concordance between mrTRG and pTRG was low (k=0.45); concordance between mrTRG_DWI and pTRG was good (k=0.73), with an AUROC of 0.85 and 0.92, respectively. The mrTRG_DWI had a sensibility and specificity, respectively, of 90% and 75%, with a correct diagnosis in 83% patients. Kaplan-Meier and log-rank tests showed a reduction of disease free survival for any increase of the TRG_DWI (p=0.004).
Conclusion
mrTRG_DWI is a valid system to assess chemoradiotherapy response and a prognostic factor. Our results suggest to implementing mrTRG_DWI in larger and prospective correlative studies as a tool to select patients for whom deferred surgery may be appropriate.
Video-on-demand
SS 11.7 - The role of gadoxetic acid-enhanced MRI in predicting post-hepatectomy liver failure after major hepatic resection for colorectal cancer metastasis after chemotherapy and diagnosing chemotherapeutic-associated liver injuries
Abstract
Purpose
To investigate whether preoperative gadoxetic acid-enhanced MRI predicts post-hepatectomy liver failure (PHLF) after major hepatic resection (MHR) for colorectal cancer (CRC) metastasis after chemotherapy and diagnosing chemotherapeutic-associated liver injuries.
Material and methods
48 patients with CRC metastasis underwent gadoxetic acid-enhanced MRI after chemotherapy and after MHR. The signal intensity of liver parenchyma was measured using regions of interest at four segments on pre-contrast T1w imaging (SIpre) and on hepatocyte phase 20 minutes after gadoxetic acid infusion (SIhp); the mean value was calculated at each phase. The relative liver enhancement (RLE) was calculated with the formula: (SIhp - SIpre)/SIpre.
Results
There was a significant correlation between aspartate aminotransferase (AST) (p<0.00001), alanine aminotransferase (ALT) (p<0.00001), indocyanine green retention test (p=0.0005), number of chemotherapy cycles (p=0.001) and RLE. 17 patients (35.42%) experienced PHLF. A significant difference of RLE in the two groups (p=0.002) was found, with a cut-off value of 0.81 (sensitivity: 64.7 %, specificity: 32.2%). 2 patients (4.17%) had certain diagnosis of nonalcoholic steatohepatitis (NASH), 15 (31.25%) uncertain and 24 (50%) had no NASH. 7 patients' data were not available. No significant difference of RLE was found between groups with and without diagnosis of NASH. Sinusoidal dilatation grade 1 was present in 13 (27.08%) patients, grade 2 in 22 (45.83%) and grade 3 in 11 (22.92%). 1 patient (2.08%) had no sinusoidal dilatation. 1 patient's data were not available. No significant correlation was found between sinusoidal dilatation grade and RLE.
Conclusion
Preoperative gadoxetic acid-enhanced MR can predict PHLF after MHR, but cannot diagnose chemotherapeutic-associated liver injuries.
Slides
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lauravercelli_902_audio_edited04_mp3 Mon, 18.05.2020 19:08
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lauravercelli.902.noaudio Wed, 13.05.2020 18:44
Author of 2 Presentations
SS 8.8 - MR tumour regression grade with diffusion-weighted imaging in locally advanced rectal cancer compared with standard MR tumour regression grade and pathological tumour regression grade: feasibility and prognostic role (ID 938)
Abstract
Purpose
Evaluate the accuracy and the prognostic role of MR tumor regression grade (TRG) after neoadjuvant radiochemotherapy (RCT) in locally advanced rectal cancers (LARC) using T2 plus diffusion-weighted imaging (DWI) sequences (mrTRG_DWI) comparing to standard T2-only mrTRG and pathological TRG (pTRG).
Material and methods
36 patients were enrolled in this retrospective study, all underwent a pre- and post-CRT conventional MRI study followed by surgical resection with a median 36-month follow-up. A 5-point mrTRG and mrTRG_DWI were assessed by two expert radiologists and finally compared with pTRG.
Results
Concordance between mrTRG and pTRG was low (k=0.45); concordance between mrTRG_DWI and pTRG was good (k=0.73), with an AUROC of 0.85 and 0.92, respectively. The mrTRG_DWI had a sensibility and specificity, respectively, of 90% and 75%, with a correct diagnosis in 83% patients. Kaplan-Meier and log-rank tests showed a reduction of disease free survival for any increase of the TRG_DWI (p=0.004).
Conclusion
mrTRG_DWI is a valid system to assess chemoradiotherapy response and a prognostic factor. Our results suggest to implementing mrTRG_DWI in larger and prospective correlative studies as a tool to select patients for whom deferred surgery may be appropriate.
Video-on-demand
SS 11.7 - The role of gadoxetic acid-enhanced MRI in predicting post-hepatectomy liver failure after major hepatic resection for colorectal cancer metastasis after chemotherapy and diagnosing chemotherapeutic-associated liver injuries (ID 902)
Abstract
Purpose
To investigate whether preoperative gadoxetic acid-enhanced MRI predicts post-hepatectomy liver failure (PHLF) after major hepatic resection (MHR) for colorectal cancer (CRC) metastasis after chemotherapy and diagnosing chemotherapeutic-associated liver injuries.
Material and methods
48 patients with CRC metastasis underwent gadoxetic acid-enhanced MRI after chemotherapy and after MHR. The signal intensity of liver parenchyma was measured using regions of interest at four segments on pre-contrast T1w imaging (SIpre) and on hepatocyte phase 20 minutes after gadoxetic acid infusion (SIhp); the mean value was calculated at each phase. The relative liver enhancement (RLE) was calculated with the formula: (SIhp - SIpre)/SIpre.
Results
There was a significant correlation between aspartate aminotransferase (AST) (p<0.00001), alanine aminotransferase (ALT) (p<0.00001), indocyanine green retention test (p=0.0005), number of chemotherapy cycles (p=0.001) and RLE. 17 patients (35.42%) experienced PHLF. A significant difference of RLE in the two groups (p=0.002) was found, with a cut-off value of 0.81 (sensitivity: 64.7 %, specificity: 32.2%). 2 patients (4.17%) had certain diagnosis of nonalcoholic steatohepatitis (NASH), 15 (31.25%) uncertain and 24 (50%) had no NASH. 7 patients' data were not available. No significant difference of RLE was found between groups with and without diagnosis of NASH. Sinusoidal dilatation grade 1 was present in 13 (27.08%) patients, grade 2 in 22 (45.83%) and grade 3 in 11 (22.92%). 1 patient (2.08%) had no sinusoidal dilatation. 1 patient's data were not available. No significant correlation was found between sinusoidal dilatation grade and RLE.
Conclusion
Preoperative gadoxetic acid-enhanced MR can predict PHLF after MHR, but cannot diagnose chemotherapeutic-associated liver injuries.
Slides
-
lauravercelli_902_audio_edited04_mp3 Mon, 18.05.2020 19:08
-
lauravercelli.902.noaudio Wed, 13.05.2020 18:44