| Added by | mollevi |
|---|---|
| Group name | EquipeMY |
| Item Type | Journal Article |
| Title | Gadolinium-Based Contrast Agent During Pelvic MRI: Contribution to Patient Management in Rectal Cancer |
| Creator | Corines et al. |
| Author | Marina J. Corines |
| Author | Stephanie Nougaret |
| Author | Martin R. Weiser |
| Author | Monika Khan |
| Author | Marc J. Gollub |
| Abstract | BACKGROUND: Few publications exist regarding gadolinium-enhanced sequences in rectal MRI. None have evaluated its potential impact on patient management. OBJECTIVE: This study aimed to assess whether gadolinium-enhanced sequences, including dynamic contrast enhancement, change radiologic interpretation and clinical management of rectal cancer. DESIGN: This is a retrospective analysis of 100 rectal MRIs (50 baseline and 50 postneoadjuvant treatment), both without and with gadolinium-enhanced sequences. Treatment plans were rendered based on each radiologic interpretation for each case by a single experienced surgeon. Differences in radiologic interpretation and management were statistically analyzed. SETTINGS: The study was conducted at the Memorial Sloan Kettering Cancer Center. PATIENTS: Patients undergoing rectal MRI between 2011 and 2015 for baseline tumor staging and/or postneoadjuvant restaging were included. MAIN OUTCOME MEASURES: Primary outcome measures were changes in radiologic tumor stage, tumor margins, and surgical planning with the use of gadolinium at baseline and postneoadjuvant time points. RESULTS: At baseline, tumor downstaging occurred in 8 (16%) of 50 and upstaging in 4 (8%) of 50 with gadolinium. Postneoadjuvant treatment, upstaging occurred in 1 (2%) of 50 from T2 to T3a. At baseline, mean distances from tumor to anorectal ring, anal verge, and mesorectal fascia were not statistically different with gadolinium. However, in 7 patients, differences could have resulted in treatment changes, accounted for by changes in relationships to anterior peritoneal reflection (n = 4), anorectal ring (n = 2), or anal verge (n = 1). Postneoadjuvant treatment, distances to anorectal ring and anal verge (in centimeters) were statistically smaller with gadolinium (p = 0.0017 and p = 0.0151) but could not have resulted in clinically significant treatment changes. LIMITATIONS: This study was limited by its retrospective design. CONCLUSIONS: The use of gadolinium at baseline MRI could have altered treatment in 24% of patients because of differences in tumor stage or position. Postneoadjuvant treatment, gadolinium resulted in statistically smaller distances to sphincters, which could influence surgical decision for sphincter-preserving rectal resection. See Video Abstract at http://links.lww.com/DCR/A444. |
| Publication | Diseases of the Colon and Rectum |
| Volume | 61 |
| Issue | 2 |
| Pages | 193-201 |
| Date | Feb 2018 |
| Journal Abbr | Dis. Colon Rectum |
| Language | eng |
| DOI | 10.1097/DCR.0000000000000925 |
| ISSN | 1530-0358 |
| Short Title | Gadolinium-Based Contrast Agent During Pelvic MRI |
| Library Catalog | PubMed |
| Extra | PMID: 29337774 PMCID: PMC5772900 |
| Tags | Adult, Aged, Aged, 80 and over, Anal Canal, Chemoradiotherapy, clinic, Gadolinium, Humans, Magnetic Resonance Imaging, Margins of Excision, Middle Aged, Neoadjuvant Therapy, Neoplasm Staging, Outcome Assessment (Health Care), Pelvis, Rectal Neoplasms, Rectum, Retrospective Studies |
| Date Added | 2018/11/13 - 17:35:18 |
| Date Modified | 2019/05/21 - 13:12:53 |
Institut de Recherche en Cancérologie de
