metricas
covid
Buscar en
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
Toda la web
Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Controversy in the initial nodal staging of rectal cancer (MRI or PET/CT?)
Journal Information
Vol. 43. Issue 3.
(May - June 2024)
Share
Share
Download PDF
More article options
Visits
5
Vol. 43. Issue 3.
(May - June 2024)
Original Article
Controversy in the initial nodal staging of rectal cancer (MRI or PET/CT?)
Controversia en la estadificación inicial ganglionar en el Ca de recto (¿RM o PET/TC?)
Visits
5
Elena López Llobeta,
Corresponding author
elena_lopez42@hotmail.com

Corresponding author.
, Mónica Coronado Poggioa, Carmen Lancha Hernándeza, Carmen Martín Hervásb, Daniela Travaglio Moralesa, Domenico Monachello Araujoa, Sonia Rodado Marinaa, Luís Domínguez Gadeaa
a Servicio de Medicina Nuclear, Hospital Universitario La Paz, Spain
b Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (3)
Table 1. Complete staging: TN defined by MRI and NM defined by PET/CT.
Table 2. Contingency table PET/CT * MRI.
Table 3. Contingency table for analysis of diagnostic accuracy using MRI and PET/CT.
Show moreShow less
Abstract
Objective

To compare the usefulness of MRI and PET/CT in nodal staging (N) of patients with locally advanced rectal cancer (LARC).

Material and methods

Retrospective study of patients with LARC, who completed their initial staging with PET/CT, between January-20 and March-23. Regional nodes were assessed, and N was determined using both techniques according to TNM criteria. Concordance between MRI and PET/CT was analyzed. The accuracy of both techniques was calculated for those patients who underwent direct surgery. Non-regional pelvic lymph nodes were evaluated by both modalities.

Results

Among the 73 patients, 48 were ultimately diagnosed with a locally advanced stage. Of these, 39 underwent neoadjuvant treatment (chemoradiotherapy) followed by surgery, and 9 direct surgery. In 25, the PET/CT extension study revealed distant disease, leading to systemic treatment. Weak concordance was observed between MRI and PET/CT in determining N (k=0.286; p<0.005). Out of 73 patients, 31(42%) exhibited concordance, and 42(58%) showed discordance. In 83% of the discordant cases, MRI overstaged compared to PET/CT, with 17 cases indicating nodal involvement (N+) by MRI and N0 by PET/CT. Diagnostic accuracy was 78% for both techniques. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 75%, 80%, and 75% for MRI, and 60%, 100%, 100%, and 67%, for PET/CT. PET/CT identified pelvic metastatic adenopathies in 8 patients that were not visible/doubtful by MRI.

Conclusions

In the initial nodal staging of rectal cancer MRI overstages relative to PET/CT. Both modalities are complementary, PET/CT offers higher specificity and MRI higher sensitivity.

Keywords:
18F-FDG PET/CT
MRI
Rectal cancer
Nodal staging
Resumen
Objetivo

Comparar la utilidad de la RM y la PET/TC en la estadificación ganglionar (N) de pacientes con cáncer de recto localmente avanzado (CRLA).

Material y métodos

Estudio retrospectivo de pacientes con CRLA, que completaron su estadificación inicial con PET/TC, entre enero-20 y marzo-23. Se valoraron los ganglios locorregionales, determinando N por ambas técnicas según TNM. Se analizó la concordancia entre RM y PET/TC. Se calculó la exactitud diagnóstica(ED) de ambas técnicas en aquellos pacientes sometidos a cirugía directa. Se evaluó la afectación ganglionar pélvica no locorregional por ambas modalidades.

Resultados

De 73 pacientes, 48 presentaron finalmente un estadio localmente avanzado, de éstos, 39 fueron tratados con neoadyuvancia (Quimio-radioterapia) y cirugía, y 9 con cirugía directa. En 25 pacientes al completar el estudio de extensión mediante PET/TC se encontró enfermedad a distancia, por lo que recibieron tratamiento sistémico. Se obtuvo concordancia débil entre RM y PET/TC para determinar N (k=0,286; p<0,005), con 31/73 (42%) concordantes y 42/73 (58%) discordantes. De los discordantes, en 35/42 (83%) la RM supraestadificó en relación al PET/TC, siendo 17 de estos N+(RM) y N0 (PET/CT). Valores de ED: 78% para ambas técnicas. S, E, VPP y VPN: del 80%, 75%, 80% y 75% para RM, y 60%, 100%, 100% y 67% para PET/CT. En 8 pacientes PET/TC identificó adenopatías metastásicas pélvicas no visibles/dudosas por RM.

Conclusiones

En la estadificación ganglionar inicial del cáncer de recto la RM supraestadifica en relación al PET/TC. Ambas modalidades son complementarias, PET/TC ofrece mayor especificidad y RM mayor sensibilidad.

Palabras clave:
18F-FDG PET/TC
RM
Ca de recto
Estadificación ganglionar

Article

These are the options to access the full texts of the publication Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Quizás le interese:
10.1016/j.remnie.2019.12.001
No mostrar más