Enhancing Precision in Rectal Cancer Care: Unravelling the Correlation Between MRI Locoregional Staging and...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Rectal cancer diagnosis and staging are critical for treatment planning.
• Preoperative Magnetic Resonance Imaging (MRI) is a key modality for assessing rectal cancer.
• Accurate locoregional staging, margin status, and vascular invasion prediction are essential for surgical outcomes.

Purpose of the Study:

• To evaluate the diagnostic accuracy of preoperative MRI pelvis for locoregional staging of rectal cancer.
• To assess MRI's ability to predict circumferential resection margin (CRM) and vascular invasion (V1).
• To compare MRI findings with postoperative histopathological results.

Main Methods:

• Retrospective analysis of 143 patients with rectal adenocarcinoma who underwent preoperative MRI.
• Comparison of MRI-based T and N staging, CRM, and V1 assessment with histopathology.
• Calculation of sensitivity, specificity, PPV, NPV, accuracy, and weighted kappa statistics.

Main Results:

• MRI accuracy was highest for T0 (97.9%) and T4 (93.37%) tumors.
• Weighted kappa for T staging was 0.401 and for N staging was 0.286, indicating fair agreement.
• Kappa for extramural vascular invasion (V) and CRM was 0.269 and 0.225, respectively.
• High specificity was observed for CRM and V1 detection.

Conclusions:

• Preoperative MRI demonstrates fair agreement with histopathology for T and N staging in rectal cancer.
• MRI exhibits high specificity in identifying the circumferential resection margin and vascular invasion.
• MRI is a valuable tool for preoperative assessment, aiding in surgical planning for rectal cancer.