ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2021
vol. 86
 
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Gastrointestinal and abdominal radiology
abstract:
Original paper

Single-centre evaluation and staging of rectal carcinoma on a 3-Tesla magnetic resonance imaging and correlation with histological profile

Jandos Amankulov
1, 2
,
Galiya Akhmetova
1
,
Dias Toleshbaev
1, 2
,
Zhamilya Zholdybay
2
,
Laura Mangitova
1
,
Dilyara Kaidarova
3

1.
Department of Radiology and Nuclear Medicine, Kazakh Institute of Oncology and Radiology, Kazakhstan
2.
Department of Visual Diagnostics, Asfendiyarov Kazakh National Medical University, Kazakhstan
3.
Department of Medical Oncology, Kazakh Institute of Oncology and Radiology, Kazakhstan
Pol J Radiol 2021; 86: e217-e224
Online publish date: 2021/04/20
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Introduction
To assess magnetic resonance imaging (MRI) features of rectal carcinoma in correlation with pathology, and to evaluate the diagnostic accuracy of 3-Tesla MRI.

Material and methods
A total of 86 patients were included. 3T MR imaging was conducted pre-operatively, with imaging data correlated to pathology results. High-resolution, 2-dimensional, T2-weighted fast-spin echo sequences in the sagittal, axial, and coronal planes used to tumour staging. Diffusion-weighted images were used to increase the accuracy of tumour evaluation.

Results
Rectal carcinoma was staged as T3 in 45.3% of all patients (n = 39), without involvement of the mesorectal fascia in 31.4% (n = 27), and with a possible or obvious invasion in 14% of patients (n = 12). The diagnostic accuracy of 3T MRI was 97.6% for the T1 stage, 92.1% for T2, 89% for T3, and 90% for T4 tumours. MR-derived extramural vascular invasion (EMVI) was found in 16.2% (n = 14), with an estimated diagnostic accuracy of 95%. Diffusion-weighted images and apparent diffusion coefficient were estimated for the different histology types of rectal carcinoma. The average apparent diffusion coefficient for adenocarcinoma was 0.846 ± 0.17, for mucinous adenocarcinoma it was 1.17 ± 0.08, and for signet cell and squamous carcinomas it was 0.91 ± 0.11 and 0.796 ± 0.21 mm2/s, respectively.

Conclusions
3T MRI enables high levels of diagnostic accuracy in local rectal carcinoma staging, including assessment of mesorectal fascia infiltration and EMVI-status with high accuracy.

keywords:

staging, magnetic resonance imaging, rectal carcinoma, tumour phenotype




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