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Recurrent rectal cancer: diagnosis with dynamic MR imaging
M Müller-Schimpfle1, G Brix, G Layer
1Research Program Radiological Diagnostics and Therapy, German Cancer Research Center, Heidelberg.
Purpose:
To evaluate whether dynamic magnetic resonance (MR) imaging can increase the diagnostic accuracy in suspected local recurrence of rectal carcinoma.
Materials And Methods:
Eighteen patients (seven men, 11 women, aged 26-78 years) with 19 suspect lesions were examined. T1-weighted (pre- and postcontrast) and T2-weighted spin-echo images were read by three observers. Computed tissue-specific enhancement parameters were obtained and displayed on gray-scale images (pharmacokinetic mapping).
Results:
Reading of the spin-echo images yielded a sensitivity of 91%-100% (confidence interval, 67%, 100%), a specificity of 29%-43% (12%, 67%), and an accuracy of 71%-75% (48%, 91%). Analysis of the MR data showed greater (P = .0038) and faster (P = .0018) enhancement of malignant lesions (n = 12) compared with benign lesions (n = 7).
Conclusion:
Pharmacokinetic mapping of dynamic MR imaging data allows in vivo insight into tissue physiopathology, helping differentiate benign from malignant pelvic lesions in rectal cancer.